Canterbury DHB

Gynaecology

• Likely pathogens: S. aureus, streptococci, anaerobes, gram-negative bacilli
• Antibiotic choice may depend on whether the procedure is vaginal, laparoscopic, or abdominal
• Antibiotic prophylaxis may not be needed for diagnostic procedures and uterine prolapse

Hysterectomy or mesh procedures

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)

Severe penicillin allergy

vancomycin HMLSchedNZFPMLnoids Vancomycin F: n/a Half life: 6 hours Elimination: renal fe: 0.9 Additional points: TDM

1 g (< 70 kg), 1.5 g (70-100 kg), or 2 g (> 100 kg)

• Must be given diluted (1 g in at least 200 mL) and slowly (≤ 1000 mg/hour) to minimise infusion reactions.

Hysteroscopy and fibroid resection, tubal dye tests, peritoneal procedures

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

Cytoscopy

must be prescribed or recommended by a consultant.

Topic Code: 99274