orthopaedic procedures

Recommendations

≥ 18 years
	Dosage	Remarks
	cefazolin IV maximum 1 day	SWAB remarks hip fractures; hip, knee, elbow, shoulder implants SWABID (National) remarks cefazolin IV 2 g single dose
	cefazolin IV maximum 1 day	SWAB remarks spinal procedures SWABID (National) remarks cefazolin IV 2 g single dose. If low back surgery (lumbar or lower) AND faecal/urinary incontinence: cefuroxime IV 1500 mg single dose.
		SWAB remarks clean procedures without implantation of prostheses or other foreign bodies: no prophylaxis

≥ 18 years

Indications: strong suspicion of or proven cefazolin allergy, or previous severe 'delayed-type' allergy to a beta-lactam antibiotic
	Dosage	Remarks
	vancomycin IV maximum 1 day or clindamycin IV maximum 1 day	SWAB remarks hip fractures; hip, knee, elbow, shoulder implants SWABID (National) remarks See vancomycin dosing clindamycin IV dose 600 mg single dose
	vancomycin IV maximum 1 day or clindamycin IV maximum 1 day	SWAB remarks spinal procedures SWABID (National) remarks See vancomycin dosing clindamycin IV dose 600 mg single dose

Comments

In hip fractures, implants and spinal procedures: in known S.aureus carriers it is recommended to add mupirocin nasal ointment.

Only administer cefazolin after taking cultures if infection is suspected. Do not perform wound swabs; at least 4 deep tissue cultures using sterile instruments.

≥ 18 years

≥ 18 years