Single dose, IV prophylaxis ≤ 60mins prior to skin incision/ intervention.
Repeat dosing of antibiotics rarely required (see NHS GGC surgical prophylaxis guidance for detail).
For gentamicin
- See appendix 1 for prophylactic dosing
- 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)
- Teicoplanin and gentamicin are incompatible when mixed directly and must not be mixed before injection.
Teicoplanin
- Give 400 mg teicoplanin by slow intravenous injection over 3-5 minutes.
- Teicoplanin and gentamicin are incompatible when mixed directly and must not be mixed before injection.
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.