Antibiotic Surgical Prophylaxis in Adults, Brachytherapy of the Prostate (901)

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A guideline is intended to assist healthcare professionals in the choice of disease-specific treatments.

Clinical judgement should be exercised on the applicability of any guideline, influenced by individual patient characteristics. Clinicians should be mindful of the potential for harmful polypharmacy and increased susceptibility to adverse drug reactions in patients with multiple morbidities or frailty.

If, after discussion with the patient or carer, there are good reasons for not following a guideline, it is good practice to record these and communicate them to others involved in the care of the patient.

Recommendations

Single dose, IV prophylaxis ≤ 60mins prior to skin incision/ intervention.

For gentamicin

  • See Gentamicin dosing table
  • Doses of up to 400mg gentamicin can be given by slow IV injection over 3 – 5 minutes
  • If subsequent treatment using gentamicin is required, measure gentamicin concentration 6-14 hours post theatre gentamicin dose, and follow GGC guidance on staffnet for gentamicin dosing. Calculate the subsequent gentamicin dose using the online calculator. Discuss with pharmacy if further advice is required (or if out of hours, the on call pharmacist)

MRSA: decolonise prior to procedure as per NHS GGC infection control guidelines and discuss with microbiology re antibiotic choice.

CPE carriers: If identified as Carbapenamase producing Enterobacterales carriers contact microbiology.

Table: Procedure > Antibiotic

Procedure Recommended antibiotic / comments
Brachytherapy IV Gentamicin single dose
(For gentamicin dosing see Gentamicin dosing table)

Last reviewed: 17 November 2020

Next review: 30 November 2023

Author(s): Ysobel Gourlay

Version: 1

Author Email(s): [email protected]

Approved By: Antimicrobial Utilisation Committee

Document Id: 901