Adult
Head & Neck Surgery including ENT
Link to General Principles, including redosing table
Head & Neck Surgery
Includes:
- Osteotomies
- Cancer surgery (including neck dissection and free-flap formation)
- Alveolar bone grafting
- Excision of ulcerated skin lesions
- Surgical removal of impacted teeth
- Traumatic facial injuries (including internal fixation of mandibular and other facial fracture)
- TMJ arthroscopy
- TMJ replacement
- Bone-anchored hearing aid (BAHA)
- Cochlear implant
Preferred (including for penicillin allergy (non-severe)): cefazolin iv (see dosing table below)
| cefazolin iv dose | |
| Weight under 50kg | 1g |
| Weight 50kg to less than 120kg | 2g |
| Weight 120kg or more | 3g |
| Creatinine Clearance less than 10ml/min or patient receiving haemodialysis | 1g |
For penicillin allergy (severe) or MRSA positive patients: teicoplanin 800mg iv
Head & neck cancer surgery - clean-contaminated/ contaminated
Preferred (including for penicillin allergy (non-severe)): cefazolin iv (see dosing table below) AND metronidazole 500mg iv
| cefazolin iv dose | |
| Weight under 50kg | 1g |
| Weight 50kg to less than 120kg | 2g |
| Weight 120kg or more | 3g |
| Creatinine Clearance less than 10ml/min or patient receiving Haemodialysis | 1g |
For penicillin allergy (severe) or MRSA positive patients, including clean-contaminated/contaminated head & neck cancer surgery:
teicoplanin 800mg iv AND metronidazole 500mg iv
Insertion of tympanostomy, myringoplasty, typanoplasty
Topical ciprofloxacin 0.3% ear drops
Routine nasal or endoscopic sinus surgery, tonsillectomy and adenoidectomy
No antibiotics required