Canterbury DHB

General Surgery

Colorectal/ appendicectomy

• Likely pathogens: Anaerobic bacteria, streptococci, aerobic Gram-negative bacilli, Enterococcus faecalis

cefazolin HMLSchedNZFPMLnoids Cefazolin F: n/a Half life: 2 hours Elimination: renal fe: 0.9

IV 2 g (IV 3 g in patients ≥ 120 kg body weight)

AND

metronidazole HMLSchedNZFPMLnoids Metronidazole F: 1 Half life: 8 hours Elimination: oxidation, glucuronidation fe: 0.1

IV 500 mg

Severe penicillin allergy

gentamicin HMLSchedNZFPMLnoids Gentamicin F: n/a Half life: 3 hours Elimination: renal fe: 0.9 Additional points: TDM.

IV 5 mg/kg ideal body weight

AND

Upper GI and Biliary Tract

• Likely pathogens: As above. Anaerobic organisms if biliary obstruction is present.

Severe penicillin allergy

If biliary obstruction present, add metronidazole IV 500 mg to cefazolin or gentamicin (as above).

must be prescribed or recommended by a consultant.

Topic Code: 99272