Vascular procedures

Perform MRSA screening prior to all planned surgery. High risk if: previous/ current MRSA carriage, hospitalisation or antibiotic therapy in previous 4 weeks, poorly controlled diabetes, tissue loss or recent foot sepsis.

Procedure Recommended Antibiotics and Comments
Above knee amputation

Flucloxacillin IV 2g + Metronidazole IV 500mg + Gentamicin IV as per Gentamicin prophylactic dosing table. Continue metronidazole oral 400mg every 8 hours for up to 5 days post op.

If penicillin allergy or high MRSA risk: Teicoplanin IV 400mg + Metronidazole IV 500mg + Gentamicin IV as per Gentamicin prophylactic dosing table. Continue metronidazole oral 400mg every 8 hours for up to 5 days post op.

Below knee amputation

Flucloxacillin IV 2g + Metronidazole IV 500mg

If penicillin allergy or high MRSA risk: Teicoplanin IV 400mg + Metronidazole IV 500mg

Arterial reconstruction / graft / prosthetic

Flucloxacillin IV 2g + Gentamicin IV as per Gentamicin prophylactic dosing table.

If penicillin allergy or high MRSA risk: Teicoplanin IV 400mg + Gentamicin IV as per Gentamicin prophylactic dosing table.

 

 

Guideline reviewed March 2024
Page updated September 2024



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