Canterbury DHB

Otolaryngology

Head and neck/ sinus

• Likely pathogens: Mixed aerobic and anaerobic upper respiratory tract flora

amoxicillin+clavulanic acid HMLSchedNZFPMLnoids Amoxicillin+Clavulanic Acid F: 0.9 / 0.5 Half life: 2 hours / 1 hour Elimination: renal fe: 0.9 / 0.5

IV 1 g/200 mg

Mild penicillin allergy

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

clindamycin HMLSchedNZFPMLnoids Clindamycin F: 0.9 Half life: 3 hours Elimination: CYP3A fe: 0.1

IV 900 mg

Rhinoplasty

• Likely pathogens: Staphylococcus aureus

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.

must be prescribed or recommended by a consultant.

Topic Code: 99277