| Procedure | Recommended Antibiotics and Comments |
| Head and neck (contaminated / clean-contaminated with skin incision) |
Amoxicillin IV 1g + Metronidazole IV 500mg + Gentamicin IV as per Gentamicin prophylactic dosing table. If penicillin allergy: Teicoplanin IV 400mg + Metronidazole IV 500mg + Gentamicin IV as per Gentamicin prophylactic dosing table. |
| Head and neck (contaminated / clean-contaminated with oral cavity incision only) |
Benzylpenicillin IV 1.2g + Metronidazole IV 500mg If penicillin allergy: Teicoplanin IV 400mg + Metronidazole IV 500mg |
| Head and neck surgery (clean, benign) |
Not recommended |
|
Open reduction and internal fixation of compound mandibular fractures Intraoral bone grafting |
Benzylpenicillin IV 1.2g + Metronidazole IV 500mg + Gentamicin IV as per Gentamicin prophylactic dosing table. If penicillin allergy: Teicoplanin IV 400mg + Metronidazole IV 500mg + Gentamicin IV as per Gentamicin prophylactic dosing table. |
| Facial plastic surgery with implant |
Amoxicillin IV 1g + Metronidazole IV 500mg + Gentamicin IV as per Gentamicin prophylactic dosing table. If penicillin allergy: Teicoplanin IV 400mg + Metronidazole IV 500mg + Gentamicin IV as per Gentamicin prophylactic dosing table. |
| Facial surgery (clean) |
Not recommended |
| Complex septorhinoplasty (including grafts)
Cleft lip and palate (major) |
Co-amoxiclav IV 1.2g If penicillin allergy: Clarithromycin IV 500mg + Metronidazole IV 500mg |
| Orthognathic surgery |
Cefuroxime IV 1.5g + Metronidazole IV 500mg |
| Cochlear implant |
Cefuroxime IV 1.5g |
|
Grommet insertion Stapedectomy |
Sofradex® ear drops topically |
|
Ear surgery (clean / clean-contaminated) Routine nose, sinus and endoscopic sinus surgery Tonsillectomy Adenoidectomy (by curettage) |
Not recommended |
| Guideline reviewed | March 2024 |
| Page updated | September 2024 |