Surgical antibiotic prophylaxis adult patients. Antimicrobial stewardship, antibiotics, antibiotic, surgical, surgery, prophylaxis, medication

Size: px
Start display at page:

Download "Surgical antibiotic prophylaxis adult patients. Antimicrobial stewardship, antibiotics, antibiotic, surgical, surgery, prophylaxis, medication"

Transcription

1 Guidelines Document Title: Document ID: Document Name: Surgical antibiotic prophylaxis adult patients GD-CLN GD-CLN Version Number: 3.4 Revision Date: 30/08/2016 Key Words Antimicrobial stewardship, antibiotics, antibiotic, surgical, surgery, prophylaxis, medication Internal Use Only: The Material within this document has been developed solely for the internal business purposes of Mater Health Services. Disclosure of information of this classification may result in a breach of statutory or regulatory obligations by the Mater. NOTICE OF CURRENCY: If viewing a printed copy of this document, NEVER assume that the printed copy being viewed is current. Always check the online Mater Document Centre to confirm you are viewing the current version of this guideline. Our Mission Our Vision Our Values In the spirit of the Sisters of Mercy, Mater Health Services offer compassionate service to the sick and needy, promotes an holistic approach to healthcare in response to changing community needs and foster high standards in health-related education and research. Following the example of Christ the healer, we commit ourselves to offering these services without discrimination. In the Mercy tradition, Mater will be renowned as a leader in the delivery of exceptional healthcare and experienced by all as a community of compassion. Mercy Dignity Care Commitment Quality Affirmation This governance document is consistent with the Mater Values and supports the Mater s Mission and Vision by establishing and mandating appropriate controls to support the delivery of health care services. Copyright Mater Misericordiae Health Services Brisbane Limited. All Rights Reserved.

2 Table of Contents 1 Document Controls Document Revision History Document Review and Approval References Introduction Purpose Scope and Context Guidelines General Information Appendices Appendix 1: MHS Recommendations for Adult Surgical Antibiotic... 6 Abdominal surgery 6 Gastrointestinal endoscopic procedures..8 Breast surgery..9 Plastic Surgery.9 Head and neck surgery..9 Vascular surgery..10 Amputation lower limb..10 Neurosurgery. 11 Cardiac surgery. 11 Thoracic surgery..11 Obstetric and gynaecological surgery..12 Orthopaedic surgery. 12 Urological surgery..13 Copyright Mater Misericordiae Health Services Brisbane Limited. All Rights Reserved.

3 1 Document Controls 1.1 Document Revision History Version Date Description 1 08-Feb-2014 Version 1 published on the Mater Document Centre 2 23-Jun-2014 Version 2 published on the Mater Document Centre 3 24-Jun-2016 Version 3 published on the Mater Document Centre Jul-2016 Amendments requested by Anna Klusak (AMS Pharmacist): a. The words endocarditis prophylaxis have been added to Abdominal surgery, Gastrointestinal endoscopic procedures, Urological surgery, and notes under Vancomycin (page 16) b. Vascular surgery and Amputation of lower limb (for patients with MRSA), additional words consider repeating dose of vancomycin* 15 mg/kg after 12 hours. c. Orthopaedic surgery (for patients with open fractures and immediate ), dose is specified at 450 mg 8 hourly where it states Continue dosing Aug-2016 Amendment requested by Nicola Townell (AMS Physician): Statement added to MHS recommendations for adult surgical antibiotic prophylaxis (top of page 6) about the timing of antibiotic administration (fifth dot point) Aug-2016 Amendment requested by Anna Klusak(AMS Pharmacist): a. Tallman lettering added throughout the document b. New content added directly under heading Plastic surgery (two dot points) Dec-2016 Amendment requested by Anna Klusak (AMS Pharmacist) to correct typo on page 16. Dosing for teicoplanin, second line, changed from greater than 80 kg to up to 80 kg. 1.2 Document Review and Approval Person Name / Committee Position (if applicable) Function (Owner Approve Review) Anna Klusak Antimicrobial Stewardship Pharmacist Document author Nicola Townell Infectious Diseases/AMS physician Document author Steve Parry-Jones Director of Pharmacy Document owner Antimicrobial Stewardship Working Party Clinical Policy Governance Committee Review/approve Endorse 1.3 References Internal Documents Document Type Document ID (with link) Document Title Governing PY-CLN Prescribing, administration and safe management of medications - adult patients Supporting PR-CLN Antimicrobial prescribing and management Document Title: Guidelines for Surgical antibiotic prophylaxis adult patients Page 3 of 17

4 PR-CLN Medication abbreviation plus Tallman Related GD-CLN Gentamicin dosing and monitoring guidelines for adult patients External Documents 1 : surgical [revised 2014 Oct] In: etg complete [Internet]. Melbourne: Therapeutic Guidelines Limited; 2015 July 2 Alfirevic Z, Gyte GML, Dou L. Different classes of antibiotics given to women routinely for preventing infection at caesarean section. Cochrane Database of Systematic Reviews 2010, Issue 10. Art. No: CD DOI: / CD Duguid M, Cruickshank M (eds). Antimicrobial Stewardship in Australian Hospitals. Australian Commission on Safety and Quality in Healthcare [online] [accessed 02/06/2014] B/$File/AMS-PRELIMS-EXEC%20SUMMARY.PDF 4 Centre for Healthcare Related Infection Surveillance and Prevention. Position Statement: Surgical Antibiotic [online] [accessed 02/06/2014] 5 van Schalkwyk J, Van Eyk N, Council of the Society of Obstetricians and Gynaecologists of Canada (SOGC). Clinical Practice Guideline. Antibiotic in Obstetric Procedures. 2010, 247, September: [online] [accessed 02/06/2014] 6 Costantine MM, Rahman M, Ghulmiyah L, Byers BD, Longo M, Wen T, Hankins GDV, Saade MD. Timing of perioperative antibiotic for caesarean section: a metaanalysis. American Journal of Obstetrics and Gynecology, 2008, 199(3): 301.e1-301.e6. 7 Sullivan SA, Smith T, Chang E, Hulsey T, Vandorsten JP, Soper DA. Administration of Cephazolin prior to skin incision is superior to Cephazolin at cord clamping in preventing postcesarean infectious morbidity: A randomized, controlled trial. American Journal of Obstetrics and Gynaecology, 2007, 196(5):455.e1-455e-5. 8 Bratzler DW, Dellinger EP, Olsen KM, Perl TM, Auwaerter PG, Bolon MK, Fish DN, Napolitano LM, Sawyer RG, Slain D, Steinberg JP, Weinstein RA. Clinical practice guidelines for antimicrobial prophylaxis in surgery. Am J Health Syst Pharm. 2011,70(1): Introduction 2.1 Purpose This guideline is to provide a standardised approach to the appropriate use and prescribing of surgical antibiotic prophylaxis to minimise surgical site infections. The objective of this guideline is to minimise the selection of antibiotic-resistant organisms and promote safe and effective antibiotic prescribing. Inappropriate prescribing is wasteful and may endanger patient wellbeing. The primary basis for decision-making approval is the latest edition of the Therapeutic Guidelines Scope and Context This guideline applies to all staff working within the Mater Health Services relating to adult patients who require surgical antibiotic prophylaxis Document Title: Guidelines for Surgical antibiotic prophylaxis adult patients Page 4 of 17

5 3 Guidelines 3.1 General Information a. The process for administration of antibiotic prophylaxis should be standardised to ensure consistent, timely administration. There is evidence to suggest that optimal timing of antibiotic prophylaxis prior to surgery is within the period minutes. Thus it is recommended that antibiotics be administered within this window. Antibiotics requiring longer infusion times should be administered such that the infusion is complete during this time. b. The guidelines for surgical antibiotic prophylaxis and the administration process should be reviewed regularly and in accordance with the published Therapeutic Guidelines. 1 c. The choice of antibiotic should be in accordance with the published Therapeutic Guidelines and be guided by previous microbiological results and known colonisations. For further advice please contact Infectious Diseases. d. Implementation of these recommendations will mean that the health service has taken responsible steps to respond to the legal duty to improve the quality of care provided with regard to the surgical antibiotic prophylaxis standard. e. The current Mater Health Services recommendations are available in all operating theatres and via the Intranet. f. Compliance with surgical antibiotic prophylaxis will be monitored via the Infection Control surgical site surveillance program and results reported to the Infection Control Committees and the Health Quality and Complaints Commission (HQCC). g. Antibiotic dose and timing must be clearly and accurately documented on the anaesthetic record. Document Title: Guidelines for Surgical antibiotic prophylaxis adult patients Page 5 of 17

6 4 Appendices 4.1 Appendix one: MHS Recommendations for adult surgical antibiotic prophylaxis MHS recommendations for adult surgical antibiotic prophylaxis If patient is known or suspected to be colonised with a resistant organism OR has a history of overseas travel (India, Asia, Southern Europe) in the last 12 months, or known contraindications to agents listed below, contact ID/Clinical Microbiology for advice Post-operative antibiotics are NOT indicated unless infection is confirmed or suspected, regardless of the presence of surgical drains or indwelling urinary catheters If infection is suspected, consider modification of antibiotic regimen according to clinical condition and microbiology results One dose of antibiotic is generally sufficient. Second dose is indicated if surgery delayed or prolonged beyond antibiotic re-dosing times- see Table A below. Antibiotics should be administered within an hour of surgical incision (ideally within minutes ) Surgical indication Table A: Recommended antibiotic re- dosing times 8 Antibiotic Re-dosing interval cefazolin 4 hours clindamycin 4 hours gentamicin NA metronidazole 12 hours vancomycin* 8 hours Abdominal surgery Table B: Recommended rates for IV infusions Antibiotic Rate clindamycin 30 mg/minute. Dilute to 18 mg/ml or weaker prior to infusion. metronidazole 25 mg/minute vancomycin* 15 mg/minute (~1g/hr) Document Title: Guidelines for Surgical antibiotic prophylaxis adult patients Page 6 of 17 Endocarditis prophylaxis: Patients with specific cardiac conditions undergoing gastrointestinal tract procedures where antibiotic prophylaxis is routinely indicated require antibiotics for the prevention of infective endocarditis. See end of table ## a) Gastroduodenal /oesophageal procedures entering GIT lumen or for procedures NOT entering the lumen, only for patients with risk factors for postoperative infection e.g. obesity; immunocompromise; gastric outlet obstruction; reduced gastric acidity or motility; gastrointestinal bleeding, malignancy or perforation b) Biliary procedures for patients with risk factors or surgical risk factors for postoperative infection e.g. older than 70 years, diabetes, obstructive jaundice, common bile duct stones, acute cholecystitis or nonfunctioning gall bladder; and open cholecystectomy Exclusions: Low risk, uncomplicated elective biliary procedures, including laparoscopic surgery prior ideally gentamicin 5 mg/kg ideal body weight IV prior ADD

7 Surgical indication Abdominal surgery Endocarditis prophylaxis: Patients with specific cardiac conditions undergoing gastrointestinal tract procedures where antibiotic prophylaxis is routinely indicated require antibiotics for the prevention of infective endocarditis. See end of table ## c) Small intestine Exclusions: endoscopic procedures If obstruction is present, metronidazole 500 mg IV prior gentamicin 5 mg/kg ideal body weight IV ideally ADD If obstruction is present, metronidazole 500 mg IV d) Colorectal surgery and appendicectomy e) hernia repair with prosthetic material (mesh) Consider IF risk factors e.g. immunocompromise, advanced age, reoperation, prolonged duration of surgery, use of surgical drains. If entry in bowel lumen expected follow colorectal and appendicectomy advice see above Exclusions: hernia repair without prosthetic material. metronidazole 500 mg IV prior prior prior gentamicin 5 mg/kg ideal body weight IV metronidazole 500 mg IV ideally ideally ADD ADD Document Title: Guidelines for Surgical antibiotic prophylaxis adult patients Page 7 of 17

8 Surgical indication Gastrointestinal endoscopic procedures Endocarditis prophylaxis: Patients with specific cardiac conditions undergoing gastrointestinal tract procedures where antibiotic prophylaxis is routinely indicated require antibiotics for the prevention of infective endocarditis. See end of table ## a) Endoscopic retrograde cholangiopancreatography (ERCP) Evidence of biliary tract obstruction where it is suspected that complete biliary drainage may not be achieved e.g. primary sclerosing cholanigitis, hilar tumours Communicating pancreatic cysts, drainage of pseudocysts. Patients with acute cholangitis should be on treatment antibiotics 1. Additional single dose- ERCP prophylaxis is not recommended. The timing of the antibiotic dose should be adjusted to achieve adequate plasma and tissue concentrations at the time of surgical incision and for the duration of the procedure. b) Endoscopic ultrasound-guided (EUG) fine-needle aspiration Only if significant bowel contamination i.e. solid lesions adjacent to lower GIT and cystic lesions adjacent to the GIT only Exclusions: Solid lesions adjacent to the upper GIT c) Gastrostomy or jejunostomy tube insertion prior metronidazole 500 mg IV prior prior gentamicin 5 mg/kg ideal body weight IV prior gentamicin 5 mg/kg ideal body weight IV metronidazole 500 mg IV prior ideally Document Title: Guidelines for Surgical antibiotic prophylaxis adult patients Page 8 of 17

9 Surgical indication a) Breast cancer surgery including lymph node exploration, reduction mammoplasty, procedures involving prosthetic implantation or wire localisation and reoperations Exclusions: wound revision, diagnostic excisional biopsy, lumpectomy without wire localisation. Breast surgery within the period minutes prior to first incision Plastic surgery ideally Continuation of antibiotic while waiting for non-infected skin graft or flaps to epithelise is not evidence based and is not recommended Application of topical antibiotics (e.g. chloramphenicol, mupirocin) to surgical infection site to prevent postoperative wound infection is not indicated a) Clean-contaminated procedures. Exclusions: clean procedures unless risk factors for postoperative infection e.g. implantation prosthetic material, prior skin irradiation or complex procedure such as TRAM within the period minutes prior to first incision Head and neck surgery ideally Patients with specific cardiac conditions undergoing tonsillectomy or adenoidectomy require antibiotics for the prevention of infective endocarditis. See end of table ## a) Incision through oral, nasal, pharyngeal or oesophageal mucosa; stapedectomy or similar operations b) Procedures that involve insertion of prosthetic material Exclusions: tonsillectomy, adenoidectomy, thyroidectomy, nasal septoplasty, endoscopic sinus surgery or uncontaminated neck dissection (for incision through mucosal surfaces) metronidazole 500mg IV prior clindamycin 900mg IV over at least 30 minutes, to be completed within the period minutes Document Title: Guidelines for Surgical antibiotic prophylaxis adult patients Page 9 of 17

10 Surgical indication Vascular surgery Reconstructive surgery involving the abdominal aorta or lower limbs and implantation foreign material Exclusions: Surgery on varicose veins where prosthetic material is NOT inserted within the period minutes prior to first incision, then 8 hourly for up to 2 further doses Amputation lower limb vancomycin* 25mg/kg ideally Consider repeating dose of vancomycin* 15mg/kg after 12 hours IF there is a risk of infection with gram negative organisms gentamicin 5mg/kg ideal body weight^ IV To be Consider repeating dose of vancomycin* 15mg/kg after 12 hours Exclusions: receiving treatment for established infection. Dose and timing should be adjusted to ensure adequate tissue concentrations at time of incision. In these patients, antibiotic treatment can be stopped 2-5 days after amputation if infected bone and tissue removed within the period minutes prior to first incision, then 8 hourly for up to 2 further doses IF limb is ischaemic ADD metronidazole 500mg IV to be Consider repeating dose of metronidazole after 12 hours vancomycin* 25mg/kg ideally Consider repeating dose of vancomycin* 15mg/kg after 12 hours gentamicin 5mg/kg ideal body weight^ IV IF limb is ischaemic ADD Consider repeating dose of vancomycin* 15mg/kg after 12 hours metronidazole 500mg IV Consider repeating dose after 12 hours. To be Document Title: Guidelines for Surgical antibiotic prophylaxis adult patients Page 10 of 17

11 Surgical indication a) Craniotomy when procedure is prolonged, reexplorations and microsurgery, insertion of prosthetic material Ventricular drains that remain in situ are not a justification to extend the duration of antibiotic prophylaxis beyond what is otherwise indicated for a specific procedure. a) Device insertions Insertion of implantable cardiac devices such as permanent pacemakers, cardioverterdefibrilators or cardiac resynchronisation devices a) Thoracic surgery including VATS procedure Neurosurgery Cardiac surgery Completed within the period minutes prior. Thoracic surgery cefazolin 2 grams IV (3g if 120kg or greater) within the period minutes prior to first incision ideally vancomycin* 25mg/kg gentamicin 5 mg/kg ideal body weight IV Completed within the period minutes prior. ideally Document Title: Guidelines for Surgical antibiotic prophylaxis adult patients Page 11 of 17

12 Surgical indication a) Caesarean section Administered before skin incision (not after cord clamping) 7 Administer to all patients including those who are already on prophylaxis for Group B Streptococcus or pre-term premature rupture of membranes (PPROM) Obstetric and gynaecological surgery b) Hysterectomy a) Prosthetic large joint replacement, procedures involving insertion of prosthetic or transplant material; internal fixation of fractures, spinal surgery and arthroscopic procedures involving insertion of prosthetic material, avascular tissue, or patient is immunocompromised. metronidazole 500mg IV Infusion to be complete within the period minutes Orthopaedic surgery. Exclusions: routine arthroscopic procedures a) Open fractures. Continue dosing 8 hourly for hours if debridement has occurred within 8 hours of injury. If more than 8 hours after injury, give presumptive treatment for 7 days, even if there is no evidence of infection clindamycin 900mg IV over at least 30 minutes, to be completed within the period minutes clindamycin 900mg IV over at least 30 minutes, to be completed within the period minutes gentamicin 5mg/kg ideal body weight^ IV intravenously within the period minutes ideally clindamycin 900mg IV over at least 30 minutes, completed within the period minutes Continue dosing at 450 mg 8 hourly for hours if debridement has occurred within 8 hours of injury. If more than 8 hours after injury, give presumptive treatment for 7 days, even if there is no evidence of infection. Switch to oral therapy when patient able to tolerate (450mg 8 hourly). Document Title: Guidelines for Surgical antibiotic prophylaxis adult patients Page 12 of 17

13 Surgical indication Urological surgery Preoperative urine cultures are recommended before elective urological procedures. Treatment is recommended for patients with significant bacteriuria even if they are asymptomatic due to increased risk of postoperative infection. Treat with a short course of antibiotics, as per recommendations for acute cystitis in adults and children in the Therapeutic Guidelines: Antibiotic 1 and guided by the results of cultures and susceptibility testing Endocarditis prophylaxis: Patients with specific cardiac conditions undergoing genitourinary tract procedures require antibiotics for the prevention of infective endocarditis. See end of table ## a) Endoscopic procedures Intrarenal and ureteric stone procedures (e.g. percutaneous nephrolithotomy, ureteroscopy or pyeloscopy for ureteric or renal stones) Specific risk for infection (e.g. resection of large or necrotic tumors, risk of bleeding, bladder outlet obstruction with incomplete bladder emptying) b) Transurethral resection of the prostate (TURP)* For recommendations for prophylaxis in radical prostatectomy, see open or laparoscopic urological procedures gentamicin 2 mg/kg IV ideal body weight^ (See table D in appendix for dosing) If gentamicin is contraindicated or relevant precautions preclude its use, REPLACE gentamicin with: gentamicin 2 mg/kg IV ideal body weight^ (See table D in appendix for dosing) gentamicin 2 mg/kg IV ideal body weight^ (See table D in appendix for dosing) If gentamicin is contraindicated or relevant precautions preclude its use, REPLACE gentamicin with: OR trimethoprim 300 mg orally, trimethoprim 300 mg orally, OR trimethoprim + sulfamethoxazole mg orally OR trimethoprim + sulfamethoxazole mg orally Document Title: Guidelines for Surgical antibiotic prophylaxis adult patients Page 13 of 17

14 Surgical indication c) Transrectal prostatic biopsy~ Urological surgery Ciprofloxacin~ 500 mg orally, as a single dose 1 to 2 hours before the procedure If procedure is delayed beyond 6 hours, repeat the dose d) Transperineal prostatic biopsy~ e) Open or laparoscopic urological procedures where the urinary tract is NOT entered* ~for patients at high risk of carriage of ciprofloxacin-resistant Enterobacteriaceae (e.g. quinolone therapy within the preceding 3 months, or travel to Asia or southern Europe within the preceding 6 months), Contact ID/Clinical microbiology for advice ideally ideally before first incision is NOT required for patients with sterile urine unless the patient has risk factors for post-operative infection or the procedure involves implantation of prosthetic devices. Consider prophylaxis where immediate operation is required and bacteriuria cannot be excluded. For implantation of prosthetic devices (e.g. penile prosthesis, artificial urinary sphincters) gentamicin 2 mg/kg ideal body weight^ IV (See table D in appendix for dosing) If gentamicin is contraindicated or relevant precautions preclude its use, REPLACE gentamicin with: REPLACE cephazolin with: ideally ideally before first incision trimethoprim 300 mg orally, OR trimethoprim + sulfamethoxazole mg orally Document Title: Guidelines for Surgical antibiotic prophylaxis adult patients Page 14 of 17

15 Surgical indication f) Open or laparoscopic urological procedures where the urinary tract IS entered* For radical prostatectomy or implantation of prosthetic devices (e.g. mesh) gentamicin 2 mg/kg ideal body weight^ IV (See table D in appendix for dosing) Urological surgery ideally gentamicin 2 mg/kg ideal body weight^ IV (See table D in appendix for dosing) ideally before first incision If gentamicin is contraindicated or relevant precautions preclude its use, REPLACE gentamicin with: trimethoprim 300 mg orally, OR trimethoprim + sulfamethoxazole mg orally IF there is a risk of entry in to the bowel lumen (e.g. ileal conduit, rectocele repair) metronidazole 500 mg IV Infusion to be completed within the period minutes If gentamicin is contraindicated or relevant precautions preclude its use, REPLACE gentamicin with: trimethoprim 300 mg orally, OR mg orally IF there is a risk of entry in to the bowel lumen (e.g. ileal conduit, rectocele repair) metronidazole 500mg IV Infusion to be completed within the period minutes Document Title: Guidelines for Surgical antibiotic prophylaxis adult patients Page 15 of 17

16 Surgical indication a) Extracorporeal Shock Wave Lithotripsy (ESWL)* only required if unknown or high risk of infection ( e.g. previous infection even if urine currently sterile or if the procedure is required immediately and bacteriuria cannot be excluded) Urological surgery gentamicin 2 mg/kg IV ideal body weight^ (See table D in appendix for dosing) a) Other clean procedures generally NOT recommended *VANCOMYCIN Maximum dose 3g Rate of 15mg/min recommended to minimise the risk of red man syndrome. Rate may be increased as tolerated Vancomycin infusion to be started at least one hour before surgery and can be continued into the operative period provided more than 75% of the dose has been administered prior to incision. Vancomycin is the preferred glycopeptide, with greater evidence to support its use in surgical prophylaxis. Tecioplanin can be used as an alternative to vancomycin in the true emergency setting or if vancomycin infusion cannot be commenced an hour prior to incision time Dosing for teicoplanin Body weight (actual) Up to 80 kg Greater than 80 kg and less than 120 kg Greater then 120 kg Dose 400 mg IV 600 mg IV 800 mg IV ##ENDOCARDITIS PROPHYLAXIS: Antibiotic prophylaxis for endocarditis is recommended in patients with the following cardiac conditions: prosthetic cardiac valve or prosthetic material used for cardiac valve repair previous infective endocarditis congenital heart disease but only if it involves: o unrepaired cyanotic defects, including palliative shunts and conduits o completely repaired defects with prosthetic material or devices, whether placed by surgery or catheter intervention, during the first 6 months after the procedure (after which the prosthetic material is likely to have been endothelialised) o repaired defects with residual defects at or adjacent to the site of a prosthetic patch or device (which inhibit endothelialisation) rheumatic heart disease in high-risk patients (Indigenous Australians and those who are at significant socioeconomic disadvantage) AND undergoing the following procedures: Abdominal surgery and Gastrointestinal endoscopic procedures : all procedures listed above except for Gastrostomy or jejunostomy tube insertion Urological surgery: All procedures involving manipulation of the urinary tract Head and neck surgery: tonsillectomy or adenoidectomy Use the following antibiotics: Where the listed regimens above do not contain vancomycin, use: amoxy/ampicillin 2 g (child: 50 mg/kg up to 2 g) IV, within 15 to 30 minutes prior to skin incision If patient is allergic to penicillin, use vancomycin*25mg/kg up to 3g. ideally Document Title: Guidelines for Surgical antibiotic prophylaxis adult patients Page 16 of 17

17 Table C: Adult gentamicin dose reference table 5 mg/kg ideal body weight*^ FEMALE Height (cm) Height (inches) IBW (kg) Dose (mg) MALE Height (cm) Height (inches) IBW (kg) Dose (mg) Table D: Adult gentamicin dose reference table 2 mg/kg ideal body weight*^ FEMALE Height (cm) Height (inches) IBW (kg) Dose (mg) MALE Height (cm) Height (inches) IBW (kg) Dose (mg) *Adult Ideal Body Weight (IBW) = 0.9kg for each cm over 152cm + 50kg (for males) or 45kg (for females). If actual body weight (ABW) less than IBW, use ABW For patients weighing greater than 20% of IBW (excluding pregnancy) use the formula: dosing weight = (IBW x [ABW - IBW]) ^Round calculated dose to nearest 40mg and infuse over 30 minutes Document Title: Guidelines for Surgical antibiotic prophylaxis adult patients Page 17 of 17

Surgical antibiotic prophylaxis paediatric patients

Surgical antibiotic prophylaxis paediatric patients Guidelines Document Title: Document ID: Document Name: Surgical antibiotic prophylaxis paediatric patients GD-CLN-700003 GD-CLN-700003 Version Number: 1.2 Revision Date: 30/08/2016 Key Words Antimicrobial

More information

VCH PHC SURGICAL PROPHYLAXIS RECOMMENDATIONS

VCH PHC SURGICAL PROPHYLAXIS RECOMMENDATIONS VCH PHC SURGICAL PROPHYLAXIS RECOMMENDATIONS CARDIAC Staphylococcus aureus, S. epidermidis, except for For patients with known MRSA colonization, recommend decolonization with Antimicrobial Photodynamic

More information

Antimicrobial Prophylaxis for Surgical and Non-surgical Procedures

Antimicrobial Prophylaxis for Surgical and Non-surgical Procedures Antimicrobial Prophylaxis for Surgical and Non-surgical Procedures Written by: Dr Linda Jewes, Consultant Microbiologist Date: April 2016 Approved by: Drugs & Therapeutics Committee Date: September 2016

More information

NHS Dumfries And Galloway. Surgical Prophylaxis Guidelines

NHS Dumfries And Galloway. Surgical Prophylaxis Guidelines NHS Dumfries And Galloway Surgical Prophylaxis Guidelines The aim of surgical prophylaxis is to reduce rates of surgical site and health-care associated infections and so reduce surgical morbidity and

More information

Antibiotic Prophylaxis Update

Antibiotic Prophylaxis Update Antibiotic Prophylaxis Update Choosing Surgical Antimicrobial Prophylaxis Peri-Procedural Administration Surgical Prophylaxis and AMS at Epworth HealthCare Mr Glenn Valoppi Dr Trisha Peel Dr Joseph Doyle

More information

SSI PREVENTION - CORRECT AND SAFE SURGICAL ANTIBIOTIC PROPHYLAXIS

SSI PREVENTION - CORRECT AND SAFE SURGICAL ANTIBIOTIC PROPHYLAXIS SSI PREVENTION - CORRECT AN SAFE SURGICAL ANTIBIOTIC PROPHYLAXIS Things you should know! There is wide consensus on specific procedures that warrant antibiotic prophylaxis as well as in which procedures

More information

SHC Surgical Antimicrobial Prophylaxis Guidelines

SHC Surgical Antimicrobial Prophylaxis Guidelines SHC Surgical Antimicrobial Prophylaxis Guidelines I. Purpose/Background This document is based upon the 2013 consensus guidelines from American Society of Health-System Pharmacists (ASHP), the Infectious

More information

Cefuroxime 1.5gm IV and Metronidazole 500mg IV. Metronidazole 500mg IV/Ampicillin-sulbactam e 3g/Ceftriaxone 2gm. +Metronidazole 500mg/Ertapenem 1gm

Cefuroxime 1.5gm IV and Metronidazole 500mg IV. Metronidazole 500mg IV/Ampicillin-sulbactam e 3g/Ceftriaxone 2gm. +Metronidazole 500mg/Ertapenem 1gm SURGICAL ANTIBIOTIC PROPHYLAXIS GENERAL SURGERY* PROCEDURE RECOMMENDED AGENTS a,b Clean None None ALTERNATIVE AGENTS (If allergic to penicillin or colonized/infected with MRSA at any site) Clean with potential

More information

Antibiotic prophylaxis guideline for colorectal, hepatobiliary and vascular surgery for adult patients.

Antibiotic prophylaxis guideline for colorectal, hepatobiliary and vascular surgery for adult patients. Antibiotic prophylaxis guideline for colorectal, hepatobiliary and vascular surgery for adult patients. Full Title of Guideline: Author (include email and role): Division & Speciality: Scope (Target audience,

More information

This is the use of antibiotics before, during and after a diagnostic, therapeutic or surgical procedure to prevent infectious complications.

This is the use of antibiotics before, during and after a diagnostic, therapeutic or surgical procedure to prevent infectious complications. Antibiotic prophylaxis in surgery CSu2 Policy Antimicrobial prophylaxis is used to reduce the incidence of post operative wound infection; patients undergoing procedures associated with high infection

More information

Hyperlink to Guideline

Hyperlink to Guideline Clinical Guideline Surgical Antibiotic Prophylaxis Sites where Clinical Guideline applies All facilities where surgery is carried out This Clinical Guideline applies to: 1. Adults Yes 2. Children up to

More information

Antimicrobial Surgical Prophylaxis

Antimicrobial Surgical Prophylaxis Antimicrobial Surgical Prophylaxis The antimicrobial surgical prophylaxis protocol establishes evidence-based standards for surgical prophylaxis at The Nebraska Medical Center. The protocol was adapted

More information

Who should read this document 2. Key practice points 2. Background/ Scope/ Definitions 2. What is new in this version 2. Policy/Procedure/Guideline 4

Who should read this document 2. Key practice points 2. Background/ Scope/ Definitions 2. What is new in this version 2. Policy/Procedure/Guideline 4 Antibiotic Guidelines Antibiotic Prophylaxis in Urology Classification: Clinical Guideline Lead Author: Antibiotic Steering Committee Additional author(s): Authors Division: DCSS & Tertiary Medicine Unique

More information

Antimicrobial Surgical Prophylaxis

Antimicrobial Surgical Prophylaxis Antimicrobial Surgical Prophylaxis The antimicrobial surgical prophylaxis protocol establishes evidence-based standards for surgical prophylaxis at Nebraska Medicine. The protocol was adapted from the

More information

Prophylactic antibiotic timing and dosage. Dr. Sanjeev Singh AIMS, Kochi

Prophylactic antibiotic timing and dosage. Dr. Sanjeev Singh AIMS, Kochi Prophylactic antibiotic timing and dosage Dr. Sanjeev Singh AIMS, Kochi Meaning - Webster Medical Definition of prophylaxis plural pro phy lax es \-ˈlak-ˌsēz\play : measures designed to preserve health

More information

Who should read this document 2. Key practice points 2. Background/ Scope/ Definitions 2. What is new in this version 3. Policy/Procedure/Guideline 3

Who should read this document 2. Key practice points 2. Background/ Scope/ Definitions 2. What is new in this version 3. Policy/Procedure/Guideline 3 Antibiotic Prophylaxis in Cranial Neurosurgery Antibiotic Classification: Clinical Guideline Lead Author: Antibiotic Steering Committee Additional author(s): as above Authors Division: DCSS & Tertiary

More information

Who should read this document 2. Key practice points 2. Background/ Scope/ Definitions 2. What is new in this version 2. Policy/Procedure/Guideline 4

Who should read this document 2. Key practice points 2. Background/ Scope/ Definitions 2. What is new in this version 2. Policy/Procedure/Guideline 4 Antibiotic Guidelines Antibiotic Prophylaxis in Urology Classification: Clinical Guideline Lead Author: Antibiotic Steering Committee Additional author(s): Authors Division: DCSS & Tertiary Medicine Unique

More information

Summary Of Adult Surgical Antibiotic Prophylaxis Guidelines For Acute Sector Staff Working Within NHS Grampian

Summary Of Adult Surgical Antibiotic Prophylaxis Guidelines For Acute Sector Staff Working Within NHS Grampian Summary Of Adult Surgical Antibiotic Prophylaxis Guidelines For Acute Sector Staff Working Within NHS Grampian Co-ordinators: Specialist Antibiotic Pharmacists Consultation Group: Antimicrobial Management

More information

Antibiotic Prophylaxis

Antibiotic Prophylaxis CLINICAL GUIDELINE Antibiotic Prophylaxis For use in (clinical areas): For use by (staff groups): For use for (patients): Document owner: Status: All clinical areas All clinicians Microbiology Consultants

More information

Gynaecological Surgery in Adults Surgical Antibiotic Prophylaxis

Gynaecological Surgery in Adults Surgical Antibiotic Prophylaxis Gynaecological Surgery in Adults Surgical Antibiotic Prophylaxis Full Title of Guideline: Author (include email and role): Division & Speciality: Scope (Target audience, state if Trust wide): Review date

More information

Treatment of Surgical Site Infection Meeting Quality Statement 6. Prof Peter Wilson University College London Hospitals

Treatment of Surgical Site Infection Meeting Quality Statement 6. Prof Peter Wilson University College London Hospitals Treatment of Surgical Site Infection Meeting Quality Statement 6 Prof Peter Wilson University College London Hospitals TEG Quality Standard 6 Treatment and effective antibiotic prescribing: People with

More information

SURGICAL ANTIBIOTIC PROPHYLAXIS GUIDELINES WITHIN ORTHOPAEDIC SURGERY FOR ADULT PATIENTS

SURGICAL ANTIBIOTIC PROPHYLAXIS GUIDELINES WITHIN ORTHOPAEDIC SURGERY FOR ADULT PATIENTS SURGICAL ANTIBIOTIC PROPHYLAXIS GUIDELINES WITHIN ORTHOPAEDIC SURGERY FOR ADULT PATIENTS Full Title of Guideline: Author (include email and role): Division & Speciality: Scope (Target audience, state if

More information

Antibiotic Prophylaxis in General Surgery Antibiotic Guidelines. Contents

Antibiotic Prophylaxis in General Surgery Antibiotic Guidelines. Contents Antibiotic Prophylaxis in General Surgery Antibiotic Guidelines Classification: Clinical Guideline Lead Author: Antibiotic Steering Committee Authors Division: CSS&TM Unique ID: 144TD(C)25(F3) Issue number:

More information

Antibiotic Prophylaxis in Spinal Surgery Antibiotic Guidelines. Contents

Antibiotic Prophylaxis in Spinal Surgery Antibiotic Guidelines. Contents Antibiotic Prophylaxis in Spinal Antibiotic Guidelines Classification: Clinical Guideline Lead Author: Antibiotic Steering Committee Additional author(s): Authors Division: DCSS & Tertiary Medicine Unique

More information

Antibiotic Prophylaxis in Adult Orthopaedic Surgery. Formulary/prescribing guideline

Antibiotic Prophylaxis in Adult Orthopaedic Surgery. Formulary/prescribing guideline Document type: Antibiotic Prophylaxis in Adult Orthopaedic Surgery Version: 2.0 Author (name): Author (designation): Validated by Formulary/prescribing guideline Dr Celia Chu, Dr Katy Edwards, Dr Pradeep

More information

Surgical antibiotic prophylaxis: Are you doing it right?

Surgical antibiotic prophylaxis: Are you doing it right? Southern African Journal of Anaesthesia and Analgesia 2018; 24(3)(Supplement 1) Open Access article distributed under the terms of the Creative Commons License [CC BY-NC-ND 4.0] http://creativecommons.org/licenses/by-nc-nd/4.0

More information

Trust Guideline for the Management of: Antibiotic Prophylaxis in adults undergoing procedures in Interventional Radiology

Trust Guideline for the Management of: Antibiotic Prophylaxis in adults undergoing procedures in Interventional Radiology Antibiotic Prophylaxis in adults undergoing procedures in Interventional Radiology A Clinical Guideline For use in: By: For: Division responsible for document: Key words: Interventional Radiology Prescribers

More information

Unique Identifier: CORP/GUID/101 Title: Antibiotic Prophylaxis In Adults Undergoing Surgery. Version Number: 2 Status: Ratified Scope: Trust Wide

Unique Identifier: CORP/GUID/101 Title: Antibiotic Prophylaxis In Adults Undergoing Surgery. Version Number: 2 Status: Ratified Scope: Trust Wide Document Type: PROCEDURE Unique Identifier: CORP/GUID/101 Title: Antibiotic Prophylaxis In Adults Undergoing Version Number: 2 Status: Ratified Scope: Trust Wide Classification: Organisational Author/Originator

More information

Antimicrobial Prophylaxis in the Surgical Patient. M. J. Osgood

Antimicrobial Prophylaxis in the Surgical Patient. M. J. Osgood Antimicrobial Prophylaxis in the Surgical Patient M. J. Osgood Outline Definitions surgical site infection (SSI) Risk factors Wound classification Microbiology of SSIs Strategies for prevention of SSIs

More information

Prescribers, trained nurses and pharmacists.

Prescribers, trained nurses and pharmacists. Title of Guideline (must include the word Guideline (not protocol, policy, procedure etc) Author: Contact Name and Job Title Directorate & Speciality Date of submission June 2015 Explicit definition of

More information

Neurosurgery Antibiotic Prophylaxis Guideline

Neurosurgery Antibiotic Prophylaxis Guideline Neurosurgery Antibiotic Prophylaxis Guideline Full Title of Guideline: Author (include email and role): Division & Speciality: Scope (Target audience, state if Trust wide): Review date (when this version

More information

See Important Reminder at the end of this policy for important regulatory and legal information.

See Important Reminder at the end of this policy for important regulatory and legal information. Clinical Policy: Reference Number: CP.HNMC.04 Effective Date: 07.01.17 Last Review Date: 02.18 Line of Business: Medicaid - HNMC Revision Log See Important Reminder at the end of this policy for important

More information

Developed by Kathy Wonderly RN, MSEd,CPHQ Developed: October 2009 Most recently updated: December 2014

Developed by Kathy Wonderly RN, MSEd,CPHQ Developed: October 2009 Most recently updated: December 2014 Developed by Kathy Wonderly RN, MSEd,CPHQ Developed: October 2009 Most recently updated: December 2014 The Center for Medicare and Medicaid (CMS) is moving away from collecting data on the process of care

More information

Responders as percent of overall members in each category: Practice: Adult 490 (49% of 1009 members) 57 (54% of 106 members)

Responders as percent of overall members in each category: Practice: Adult 490 (49% of 1009 members) 57 (54% of 106 members) Infectious Diseases Society of America Emerging Infections Network 6/2/10 Report for Query: Perioperative Staphylococcus aureus Screening and Decolonization Overall response rate: 674/1339 (50.3%) physicians

More information

Women s Antimicrobial Guidelines Summary

Women s Antimicrobial Guidelines Summary Women s Antimicrobial Guidelines Summary 1. Introduction and Who Guideline applies to This guideline has been developed to deliver safe and appropriate empirical use of antibiotics for patients at University

More information

NQF-ENDORSED VOLUNTARY CONSENSUS STANDARDS FOR HOSPITAL CARE. Measure Information Form Collected For: CMS Voluntary Only

NQF-ENDORSED VOLUNTARY CONSENSUS STANDARDS FOR HOSPITAL CARE. Measure Information Form Collected For: CMS Voluntary Only Last Updated: Version 4.4a NQF-ENDORSED VOLUNTARY CONSENSUS STANDARDS FOR HOSPITAL CARE Measure Infmation Fm Collected F: CMS Voluntary Only Measure Set: Surgical Care Improvement Project (SCIP) Set Measure

More information

The Effect of Perioperative Use of Prophylactic Antibiotics on Surgical Wound Infection

The Effect of Perioperative Use of Prophylactic Antibiotics on Surgical Wound Infection THE IRAQI POSTGRADUATE MEDICAL JOURNAL PROPHYLACTIC ANTIBIOTICS ON SURGICAL WOUND INFECTION The Effect of Perioperative Use of Prophylactic Antibiotics on Surgical Wound Infection Ahmed Hamid Jasim*, Nabeel

More information

Objectives. Antibiotic Prophylaxis in Urologic Procedures: A Review of the CUA Guidelines & Local Epidemiology of Drug Resistance

Objectives. Antibiotic Prophylaxis in Urologic Procedures: A Review of the CUA Guidelines & Local Epidemiology of Drug Resistance Antibiotic Prophylaxis in Urologic Procedures: A Review of the CUA Guidelines & Local Epidemiology of Drug Resistance David Hogarth UBC Urology PGY-1 May 24, 2017 Objectives 1. To review the current CUA

More information

Antimicrobial Stewardship

Antimicrobial Stewardship Antimicrobial Stewardship Report: 11 th August 2016 Issue: As part of ensuring compliance with the National Safety and Quality Health Service Standards (NSQHS), Yea & District Memorial Hospital is required

More information

GUIDELINE FOR ANTIMICROBIAL USE IN THE ORTHOPAEDIC AND TRAUMA DEPARTMENT

GUIDELINE FOR ANTIMICROBIAL USE IN THE ORTHOPAEDIC AND TRAUMA DEPARTMENT GUIDELINE FOR ANTIMICROBIAL USE IN THE ORTHOPAEDIC AND TRAUMA DEPARTMENT Written by: Dr Ken. N. Agwuh, Consultant Microbiologist Mr Roger Helm, Consultant Orthopaedic Surgeon Mr T Kumar, Consultant Orthopaedic

More information

PDP can be completed in the context of small animal, equine or farm animal practice, or any combination of these three.

PDP can be completed in the context of small animal, equine or farm animal practice, or any combination of these three. Clinical procedures checklists DRAFT REVISIONS PDP can be completed in the context of small animal, equine or farm animal practice, or any combination of these three. RCVS YEAR ONE CLINICAL PROCEDURES

More information

Adult Interventional Radiology Prophylaxis Antibiotic Guideline Providence Alaska Medical Center Last Updated: March 2015

Adult Interventional Radiology Prophylaxis Antibiotic Guideline Providence Alaska Medical Center Last Updated: March 2015 Page 1 of 9 Adult Interventional Radiology Prophylaxis Antibiotic Guideline Providence Alaska Medical Center Last Updated: March 2015 Introduction 1 : Antimicrobial prophylaxis prior to Interventional

More information

OBSTETRICS & GYNAECOLOGY. Penicillin G 5 million units IV ; followed by 2.5 million units 4hourly upto delivery

OBSTETRICS & GYNAECOLOGY. Penicillin G 5 million units IV ; followed by 2.5 million units 4hourly upto delivery OBSTETRICS & GYNAECOLOGY A.OBSTETRICS Infection/Condition/likely organism Intrapartum Group B Streptococcal (GBS) infection; positive mothers Suggested treatment Preferred Penicillin G 5 million units

More information

See Important Reminder at the end of this policy for important regulatory and legal information.

See Important Reminder at the end of this policy for important regulatory and legal information. Clinical Policy: Reference Number: CP.HNMC.24 Effective Date: 07.01.17 Last Review Date: 02.18 Line of Business: Medicaid - HNMC Revision Log See Important Reminder at the end of this policy for important

More information

Treatment of peritonitis in patients receiving peritoneal dialysis Antibiotic Guidelines. Contents

Treatment of peritonitis in patients receiving peritoneal dialysis Antibiotic Guidelines. Contents Treatment of peritonitis in patients receiving Antibiotic Guidelines Classification: Clinical Guideline Lead Author: Jude Allen (Pharmacist) Additional author(s): Dr David Lewis, Dr Dimitrios Poulikakos,

More information

Patients. Excludes paediatrics, neonates.

Patients. Excludes paediatrics, neonates. Full title of guideline Author Division & Speciality Scope Gentamicin Prescribing Guideline For Adult Patients Annette Clarkson, Specialist Clinical Pharmacist Antimicrobials and Infection Control All

More information

DATA COLLECTION SECTION BY FRONTLINE TEAM. Patient Identifier/ Medical Record number (for facility use only)

DATA COLLECTION SECTION BY FRONTLINE TEAM. Patient Identifier/ Medical Record number (for facility use only) Assessment of Appropriateness of ICU Antibiotics (Patient Level Sheet) **Note this is intended for internal purposes only. Please do not return to PQC.** For this assessment, inappropriate antibiotic use

More information

Preventing Surgical Site Infections. Edward L. Goodman, MD September 16, 2013

Preventing Surgical Site Infections. Edward L. Goodman, MD September 16, 2013 Preventing Surgical Site Infections Edward L. Goodman, MD September 16, 2013 Outline NHSN Reporting and Definitions Magnitude of the Problem Risk Factors Non Pharmacologic Interventions Pharmacologic Interventions

More information

Scottish Surveillance of Healthcare Infection Programme (SSHAIP) Health Protection Scotland SSI Surveillance Protocol 7th Edition 2017 Question &

Scottish Surveillance of Healthcare Infection Programme (SSHAIP) Health Protection Scotland SSI Surveillance Protocol 7th Edition 2017 Question & Contents General... 4 Pre-op... 4 Peri-op... 5 Post-op... 8 Caesarean Section... 12 Orthopaedics... 14 Large Bowel:... 15 Vascular... 17 General Pre-op Q: If a patient is an emergency admission is the

More information

Clinical Guideline. District Infectious Diseases Management. Go to Guideline. District Infectious Diseases Management CG 18_24

Clinical Guideline. District Infectious Diseases Management. Go to Guideline. District Infectious Diseases Management CG 18_24 Clinical Guideline District Infectious Diseases Management Sites where Clinical Guideline applies All facilities This Clinical Guideline applies to: 1. Adults Yes 2. Children up to 16 years Yes 3. Neonates

More information

Antibiotic Usage Guidelines in Hospital

Antibiotic Usage Guidelines in Hospital SUPPLEMENT TO JAPI december VOL. 58 51 Antibiotic Usage Guidelines in Hospital Camilla Rodrigues * Use of surveillance data information of Hospital antibiotic policy guidelines from Hinduja Hospital. The

More information

Acute Pyelonephritis POAC Guideline

Acute Pyelonephritis POAC Guideline Acute Pyelonephritis POAC Guideline Refer full regional pathway http://aucklandregion.healthpathways.org.nz/33444 EXCLUSION CRITERIA: COMPLICATED PYELONEPHRITIS Discuss with relevant specialist for advice

More information

Antibiotic Guideline: Empirical Treatment of Bone and Joint Infection in Adults

Antibiotic Guideline: Empirical Treatment of Bone and Joint Infection in Adults Antibiotic Guideline: Empirical Treatment of Bone and Joint Infection in Adults Document type: Prescribing guideline Version: 5.0 Author (name and designation) Samim Patel, Antimicrobial Lead Pharmacist

More information

ASHP Therapeutic Guidelines on Antimicrobial Prophylaxis in Surgery

ASHP Therapeutic Guidelines on Antimicrobial Prophylaxis in Surgery 426 ASHP Therapeutic Guidelines ASHP Therapeutic Guidelines on Antimicrobial Prophylaxis in Surgery The ASHP Therapeutic Guidelines on Antimicrobial Prophylaxis in Surgery, 1 which have provided practitioners

More information

your hospitals, your health, our priority STANDARD OPERATING PROCEDURE: ANTIBIOTICS FOR SURGICAL PATIENTS SOP NO: TW SOP 3 VERSION NO: 9

your hospitals, your health, our priority STANDARD OPERATING PROCEDURE: ANTIBIOTICS FOR SURGICAL PATIENTS SOP NO: TW SOP 3 VERSION NO: 9 STANDARD OPERATING PROCEDURE: ANTIBIOTICS FOR SURGICAL PATIENTS SOP NO: TW10-136 SOP 3 VERSION NO: 9 APPROVING COMMITTEE: DATE THIS VERSION APPROVED: RATIFYING COMMITTEE: DATE THIS VERSION RATIFIED: AUTHOR(S)

More information

Who should read this document? 2. Key practice points 2. Background/ Scope/ Definitions 2. What is new in this version? 3

Who should read this document? 2. Key practice points 2. Background/ Scope/ Definitions 2. What is new in this version? 3 Neurosurgical infections (adult only) Antibiotic Guidelines Classification: Clinical Guideline Lead Author: Antibiotic Steering Committee Additional author(s): as above Authors Division: DCSS & Tertiary

More information

Clinical Practice Guidelines for Antimicrobial Prophylaxis in Surgery

Clinical Practice Guidelines for Antimicrobial Prophylaxis in Surgery 654 ASHP Therapeutic Guidelines Clinical Practice Guidelines for Antimicrobial Prophylaxis in Surgery These guidelines were developed jointly by the American Society of Health-System Pharmacists (ASHP),

More information

Surgical prophylaxis for Gram +ve & Gram ve infection

Surgical prophylaxis for Gram +ve & Gram ve infection Surgical prophylaxis for Gram +ve & Gram ve infection Professor Mark Wilcox Clinical l Director of Microbiology & Pathology Leeds Teaching Hospitals & University of Leeds, UK Heath Protection Agency Surveillance

More information

Surgical Antibiotic Prophylaxis: Adherence to hospital s guidelines

Surgical Antibiotic Prophylaxis: Adherence to hospital s guidelines Surgical Antibiotic Prophylaxis: Adherence to hospital s guidelines Abstract Aim: This study was designed to assess the compliance to local hospital guidelines for antimicrobial prophylaxis in general

More information

GASTRO-INTESTINAL TRACT INFECTIONS - ANTIMICROBIAL MANAGEMENT

GASTRO-INTESTINAL TRACT INFECTIONS - ANTIMICROBIAL MANAGEMENT GASTRO-INTESTINAL TRACT INFECTIONS - ANTIMICROBIAL MANAGEMENT DRAFT AS CURRENTLY OUT FOR CONSULTATION BUT CAN BE UTILISED IN PRESENT FORMAT Name & Title Of Author: Date Revised: Approved by Committee/Group:

More information

Measure #20 (NQF 0270): Perioperative Care: Timing of Prophylactic Parenteral Antibiotic Ordering Physician

Measure #20 (NQF 0270): Perioperative Care: Timing of Prophylactic Parenteral Antibiotic Ordering Physician Measure #20 (NQF 0270): Perioperative Care: Timing of Prophylactic Parenteral Antibiotic Ordering Physician 2014 PQRS OPTIONS FOR INDIVIDUAL MEASURES: CLAIMS, REGISTRY DESCRIPTION: Percentage of surgical

More information

Prevention of surgical site infections (SSI) nosocomial infection * - Lead to prolonged hospital stay and increased coasts

Prevention of surgical site infections (SSI) nosocomial infection * - Lead to prolonged hospital stay and increased coasts Antibiotic Prophylaxis in Surgery Birgit Ross, MD Dep. of Hospital Hygiene University Hospital and Clinics, Essen Prevention of surgical site infections (SSI) - Surgical site infections account for approximately

More information

Antibiotics in the trenches: An ER Doc s Perspective

Antibiotics in the trenches: An ER Doc s Perspective Antibiotics in the trenches: An ER Doc s Perspective Peter Currie, MD Medical Director for Quality Emergency Physicians Professional Association (EPPA) Agenda Emergency Medicine Specific Disease Processes

More information

Bugs & Drugs RECOMMENDED DRUG REGIMENS FOR SURGICAL PROPHYLAXIS IN ADULT PATIENTS

Bugs & Drugs RECOMMENDED DRUG REGIMENS FOR SURGICAL PROPHYLAXIS IN ADULT PATIENTS GENERAL PRINCIPLES 1. The goal of antimicrobial surgical prophylaxis is to achieve serum and tissue antibiotic concentrations that exceed the minimum inhibity concentrations (MICs) of the majity of ganisms

More information

POTENTIAL STRUCTURE INDICATORS FOR EVALUATING ANTIMICROBIAL STEWARDSHIP PROGRAMMES IN EUROPEAN HOSPITALS

POTENTIAL STRUCTURE INDICATORS FOR EVALUATING ANTIMICROBIAL STEWARDSHIP PROGRAMMES IN EUROPEAN HOSPITALS POTENTIAL STRUCTURE INDICATORS FOR EVALUATING ANTIMICROBIAL STEWARDSHIP PROGRAMMES IN EUROPEAN HOSPITALS Dirk VOGELAERS Department of General Internal Medicine, Infectious Diseases and Psychosomatic Medicine

More information

National Antimicrobial Prescribing Survey

National Antimicrobial Prescribing Survey Indication documented Surgical prophylaxis >24 hrs Allergy mismatch Microbiology mismatch Incorrect route Incorrect dose/frequency Incorrect duration Therapeutic Guidelines Local guidelines * Non-compliant

More information

ANTIBIOTIC PRESCRIBING POLICY FOR DIABETIC FOOT DISEASE IN SECONDARY CARE

ANTIBIOTIC PRESCRIBING POLICY FOR DIABETIC FOOT DISEASE IN SECONDARY CARE ANTIBIOTIC PRESCRIBING POLICY FOR DIABETIC FOOT DISEASE IN SECONDARY CARE Version 1.0 Date ratified June 2009 Review date June 2011 Ratified by Authors Consultation Nottingham Antibiotic Guidelines Committee

More information

In an effort to help reduce surgical site infections, Surgical Services associates will be expected to observe the following guidelines:

In an effort to help reduce surgical site infections, Surgical Services associates will be expected to observe the following guidelines: To: Dept. of Surgery Associates From: Gloria Karr, Dir. Infection Prevention Date: May, 2012 Re: Guidelines for Infection Control in In an effort to help reduce surgical site infections, Surgical Services

More information

Intra-Abdominal Infections. Jessica Thompson, PharmD, BCPS (AQ-ID) Infectious Diseases Pharmacy Clinical Specialist Renown Health April 19, 2018

Intra-Abdominal Infections. Jessica Thompson, PharmD, BCPS (AQ-ID) Infectious Diseases Pharmacy Clinical Specialist Renown Health April 19, 2018 Intra-Abdominal Infections Jessica Thompson, PharmD, BCPS (AQ-ID) Infectious Diseases Pharmacy Clinical Specialist Renown Health April 19, 2018 Select guidelines Mazuski JE, et al. The Surgical Infection

More information

CODING GUIDELINES CODING GUIDELINES - OPCS NEW PAIR CODES...6 ERRATA...7. No. 18 May, 2006

CODING GUIDELINES CODING GUIDELINES - OPCS NEW PAIR CODES...6 ERRATA...7. No. 18 May, 2006 CODING GUIDELINES No. 18 May, 2006 Please note that the Coding Advisory Service Telephone Number is 0131-275-7283. The number is manned Tuesday to Thursday from 09.00 to 17.00 hrs. The link for previous

More information

Peri-operative Antibiotic Prophylaxis. 2 nd QI Cycle results Compiled by: Dr Stella Sasha

Peri-operative Antibiotic Prophylaxis. 2 nd QI Cycle results Compiled by: Dr Stella Sasha Peri-operative Antibiotic Prophylaxis 2 nd QI Cycle results Compiled by: Dr Stella Sasha 2 nd QI cycle 4 weeks (11 April 8 May) Elective MIS cases Hysterectomy +/- salpingo-oophorectomy Myomectomy Oophorectomy

More information

Health Service Executive South East Acute Hospitals

Health Service Executive South East Acute Hospitals Page No: 1 of 29 Health Service Executive South East Acute Hospitals SOUTH EAST ACUTE HOSPITALS SURGICAL PROPHYLAXIS GUIDELINES ASG 003 Page No: 2 of 29 Document Reference Number Revision Number Document

More information

Surgical Site Infections (SSIs)

Surgical Site Infections (SSIs) Surgical Site Infections (SSIs) Postoperative infections presenting at any level Incisional superficial (skin, subcutaneous tissue) Incisional deep (fascial plane and muscles) Organ/space related (anatomic

More information

Safe Patient Care Keeping our Residents Safe Use Standard Precautions for ALL Residents at ALL times

Safe Patient Care Keeping our Residents Safe Use Standard Precautions for ALL Residents at ALL times Safe Patient Care Keeping our Residents Safe 2016 Use Standard Precautions for ALL Residents at ALL times #safepatientcare Do bugs need drugs? Dr Deirdre O Brien Consultant Microbiologist Mercy University

More information

Paediatric Empirical Antimicrobial Guidance for Infections in Hospital

Paediatric Empirical Antimicrobial Guidance for Infections in Hospital Paediatric Empirical Antimicrobial Guidance for Infections in Hospital This guidance is for empirical treatment. Alternative antibiotics may be required if specific pathogens are identified or there is

More information

Intro Who should read this document 2 Key practice points 2 Background 2

Intro Who should read this document 2 Key practice points 2 Background 2 Antibiotic Guidelines: Obstetric Anti-Infective Prescribing Guidelines Classification: Clinical Guideline Lead Author: Antibiotic Steering Committee Additional author(s): Kelly Alexander / Frances Garraghan

More information

Neonatal Antibiotic Prophylaxis and Surgical Site Infection Adam C. Alder, MD MSCS Ryan Walk, MD UTSW and Children s Health Dallas, TX

Neonatal Antibiotic Prophylaxis and Surgical Site Infection Adam C. Alder, MD MSCS Ryan Walk, MD UTSW and Children s Health Dallas, TX Neonatal Antibiotic Prophylaxis and Surgical Site Infection Adam C. Alder, MD MSCS Ryan Walk, MD UTSW and Children s Health Dallas, TX Nothing to disclose Disclosures Objectives Review the current challenges

More information

Measure Information Form

Measure Information Form Release Notes: Measure Information Form Version 2.4 **NQF-NORS VOLUNTARY CONSNSUS STANARS FOR HOSPITAL CAR** Measure Information Form Measure Set: Surgical Care Improvement Project (SCIP) Set Measure I

More information

GUIDELINES FOR THE MANAGEMENT OF COMMUNITY-ACQUIRED PNEUMONIA IN ADULTS

GUIDELINES FOR THE MANAGEMENT OF COMMUNITY-ACQUIRED PNEUMONIA IN ADULTS Version 3.1 GUIDELINES FOR THE MANAGEMENT OF COMMUNITY-ACQUIRED PNEUMONIA IN ADULTS Date ratified June 2008 Updated March 2009 Review date June 2010 Ratified by Authors Consultation Evidence base Changes

More information

Objectives. Review basic categories of intra-abdominal infection and their respective treatments. Community acquired intra-abdominal infection

Objectives. Review basic categories of intra-abdominal infection and their respective treatments. Community acquired intra-abdominal infection Objectives Review basic categories of intra-abdominal infection and their respective treatments Community acquired intra-abdominal infection Mild/Moderate Severe Acute biliary tract infections Nosocomial

More information

Prevention & Management of Infection post Trans Rectal Ultrasound (TRUS) biopsy

Prevention & Management of Infection post Trans Rectal Ultrasound (TRUS) biopsy Prevention & Management of Infection post Trans Rectal Ultrasound (TRUS) biopsy Dr. Fidelma Fitzpatrick Consultant Microbiologist, Co-chair, NCCP Prostate Bx Infection Project Board Fidelma.fitzpatrick@hse.ie

More information

Guidelines for the Empirical Treatment of Sepsis in Adults (excluding Neutropenic Sepsis)

Guidelines for the Empirical Treatment of Sepsis in Adults (excluding Neutropenic Sepsis) Guidelines for the Empirical Treatment of Sepsis in Adults (excluding Neutropenic Sepsis) Full Title of Guideline: Author (include email and role): Division & Speciality: Scope (Target audience, state

More information

Guideline for Acute Upper Abdo pain 2.0 FINAL. Guideline adopted from the Bedside Clinical Guideline Partnership

Guideline for Acute Upper Abdo pain 2.0 FINAL. Guideline adopted from the Bedside Clinical Guideline Partnership Guideline for Acute Upper Abdo pain 2.0 FINAL Guideline adopted from the Bedside Clinical Guideline Partnership EQUALITY IMPACT The Trust strives to ensure equality of opportunity for all both as a major

More information

NQF-ENDORSED VOLUNTARY CONSENSUS STANDARDS FOR HOSPITAL CARE. Measure Information Form Collected For: CMS Voluntary Only

NQF-ENDORSED VOLUNTARY CONSENSUS STANDARDS FOR HOSPITAL CARE. Measure Information Form Collected For: CMS Voluntary Only Last Updated: Version 4.4a NQF-ENORSE VOLUNTARY CONSENSUS STANARS FOR HOSPITAL CARE Measure Information Form Collected For: CMS Voluntary Only Measure Set: Surgical Care Improvement Project (SCIP) Set

More information

Antimicrobial prophylaxis. Bs Lưu Hồ Thanh Lâm Bv Nhi Đồng 2

Antimicrobial prophylaxis. Bs Lưu Hồ Thanh Lâm Bv Nhi Đồng 2 Antimicrobial prophylaxis Bs Lưu Hồ Thanh Lâm Bv Nhi Đồng 2 Definition The United States Centers for Disease Control and Prevention (CDC) has developed criteria that define surgical site infection (SSI)

More information

your hospitals, your health, our priority PARC (Policy Approval and Ratification Committee) STANDARD OPERATING PROCEDURE:

your hospitals, your health, our priority PARC (Policy Approval and Ratification Committee) STANDARD OPERATING PROCEDURE: STANDARD OPERATING PROCEDURE: TRUST ANTIBIOTIC TREATMENT SOP SOP NO: TW10/136 SOP 1 VERSION NO: VERSION 6.1 (JANUARY 2013) APPROVING COMMITTEE: INFECTION PREVENTION AND CONTROL COMMITTEE DATE THIS VERSION

More information

CHEMOPROPHYLAXIS IN CAESAREAN SECTION

CHEMOPROPHYLAXIS IN CAESAREAN SECTION ORIGINAL ARTICLE CHEMOPROPHYLAXIS IN CAESAREAN SECTION TAYYEBA ANBREEN, JAHAN ARA, LUBNA ALI, SUBHANA TAYYAB ABSTRACT Objective Study design Place & Duration of study Methodology Results Conclusion Key

More information

Antimicrobial Stewardship Programs The Same, but Different. Sara Nausheen, MD Kevin Kern, PharmD

Antimicrobial Stewardship Programs The Same, but Different. Sara Nausheen, MD Kevin Kern, PharmD Antimicrobial Stewardship Programs The Same, but Different Sara Nausheen, MD Kevin Kern, PharmD Antimicrobial Stewardship Programs The Same, but Different Objectives: Outline the overall function of an

More information

They are updated regularly as new NICE guidance is published. To view the latest version of this NICE Pathway see:

They are updated regularly as new NICE guidance is published. To view the latest version of this NICE Pathway see: Antibiotic treatment and monitoring for suspected or confirmed early-onset neonatal infection bring together everything NICE says on a topic in an interactive flowchart. are interactive and designed to

More information

Antimicrobial Prophylaxis in Digestive Surgery

Antimicrobial Prophylaxis in Digestive Surgery Antimicrobial Prophylaxis in Digestive Surgery Toar JM. Lalisang, MD, PhD Digestive Surgery Division Cipto Mangunkusumo Hospital Medical Faculty Universitas Indonesia Antibiotic must be present before

More information

Australian and New Zealand College of Veterinary Scientists. Fellowship Examination. Small Animal Surgery Paper 1

Australian and New Zealand College of Veterinary Scientists. Fellowship Examination. Small Animal Surgery Paper 1 Australian and New Zealand College of Veterinary Scientists Fellowship Examination June 2017 Small Animal Surgery Paper 1 Perusal time: Twenty (20) minutes Time allowed: Three (3) hours after perusal Answer

More information

Treatment of septic peritonitis

Treatment of septic peritonitis Vet Times The website for the veterinary profession https://www.vettimes.co.uk Treatment of septic peritonitis Author : Andrew Linklater Categories : Companion animal, Vets Date : November 2, 2016 Septic

More information

UPDATE ON ANTIMICROBIAL STEWARDSHIP REGULATIONS AND IMPLEMENTATION OF AN AMS PROGRAM

UPDATE ON ANTIMICROBIAL STEWARDSHIP REGULATIONS AND IMPLEMENTATION OF AN AMS PROGRAM UPDATE ON ANTIMICROBIAL STEWARDSHIP REGULATIONS AND IMPLEMENTATION OF AN AMS PROGRAM Diane Rhee, Pharm.D. Associate Professor of Pharmacy Practice Roseman University of Health Sciences Chair, Valley Health

More information

PIPERACILLIN- TAZOBACTAM INJECTION - SUPPLY PROBLEMS

PIPERACILLIN- TAZOBACTAM INJECTION - SUPPLY PROBLEMS PIPERACILLIN- TAZOBACTAM INJECTION - SUPPLY PROBLEMS The current supply of piperacillin- tazobactam should be reserved f Microbiology / Infectious Diseases approval and f neutropenic sepsis, severe sepsis

More information

Surgical Cross Coder. Essential links from CPT codes to ICD-9-CM and HCPCS codes

Surgical Cross Coder. Essential links from CPT codes to ICD-9-CM and HCPCS codes Essential links from CPT codes to ICD-9-CM and HCPCS codes 2016 Contents Introduction... iii Cardiovascular System...527 Digestive System...707 General...1 Integumentary System...9 Musculoskeletal System...173

More information

Clinical Practice Standard

Clinical Practice Standard Clinical Practice Standard 1-20-6-1-010 TITLE: INTRAVENOUS TO ORAL CONVERSION FOR ANTIMICROBIALS A printed copy of this document may not reflect the current, electronic version on OurNH. APPLICABILITY:

More information

Measure #21 (NQF 0268): Perioperative Care: Selection of Prophylactic Antibiotic First OR Second Generation Cephalosporin

Measure #21 (NQF 0268): Perioperative Care: Selection of Prophylactic Antibiotic First OR Second Generation Cephalosporin Measure #21 (NQF 0268): Perioperative Care: Selection of Prophylactic Antibiotic First OR Second Generation Cephalosporin 2013 PQRS OPTIONS FOR INDIVIDUAL MEASURES: CLAIMS, REGISTRY DESCRIPTION: Percentage

More information

Multi-Drug Resistant Gram Negative Organisms POLICY REVIEW DATE EXTENDED Printed copies must not be considered the definitive version

Multi-Drug Resistant Gram Negative Organisms POLICY REVIEW DATE EXTENDED Printed copies must not be considered the definitive version Multi-Drug Resistant Gram Negative Organisms POLICY REVIEW DATE EXTENDED 2018 Printed copies must not be considered the definitive version DOCUMENT CONTROL POLICY NO. IC-122 Policy Group Infection Control

More information

Standing Orders for the Treatment of Outpatient Peritonitis

Standing Orders for the Treatment of Outpatient Peritonitis Standing Orders for the Treatment of Outpatient Peritonitis 1. Definition of Peritonitis: a. Cloudy effluent. b. WBC > 100 cells/mm3 with >50% polymorphonuclear (PMN) cells with minimum 2 hour dwell. c.

More information

Surgical Site Infection Prevention

Surgical Site Infection Prevention Surgical Site Infection Prevention A Clinical Practice Guideline developed by the University of Toronto s Best Practice in Surgery in collaboration with the Antimicrobial Stewardship Program P Bonnar,

More information