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Recommendations

≥ 18 years

Indications: Percutaneous renal surgery

Дозування Ремарки
cefuroxime iv 1500 mg single dose

Percutaneous nephrolithotomy (PNL)

Transabdominal radical nephrectomy

NO PROPHYLAXIS

cefuroxime iv 1500 mg single dose

or

ciprofloxacin po 500 mg single dose

Insertion/change of nephrostomy catheter (NSK)

(or guided by recent culture)

Donor nephrectomy (living donor)

A urine culture is always performed during the donor screening process. Any bacteriuria is treated.

Perioperative NO PROPHYLAXIS

Donor nephrectomy (deceased donor)

Positive blood cultures or confirmed infections should be treated in consultation with the transplant physician (see NTS 2018 document)

cefuroxime iv 1500 mg single dose

Donor kidney implantation (recipient)

The recipient receives perioperative prophylaxis regardless of the kidney's origin (living or deceased donor)

≥ 18 years

Indications: Abdominal surgery

Дозування Ремарки
cefuroxime iv 1500 mg single dose

Open prostatectomy

piperacillin/tazobactam iv 4500 mg single dose

Radical cystectomy with creation of urostomy (Hautmann, Bricker, Indiana pouch)

piperacillin/tazobactam iv 4500 mg single dose

Removal of splints after radical cystectomy

ciprofloxacin po 500 mg 2x daily for 1 day

Transrectal prostate biopsy

2 hours before the procedure and repeat 10 hours after the procedure

ciprofloxacin po 500 mg 2x daily for 1 week

MRI Cryo and MRI Tulsa

extended prophylaxis for 1 week

piperacillin/tazobactam iv 4500 mg single dose

Removal of TUC after Hryntschak

≥ 18 years

Indications: Transurethral surgery

Дозування Ремарки

Diagnostic cystoscopy

NO PROPHYLAXIS

≥ 18 years

Indications: Transurethral surgery

Дозування Ремарки
cefuroxime iv 1500 mg single dose

Transurethral prostate procedures (TURP, GGL)

If a bladder catheter or suprapubic catheter is in situ preoperatively, treat bacteriuria first with 5 days of antibiotics guided by culture. Also change the catheter under antibiotic therapy. Regardless of catheter, always provide perioperative prophylaxis.

cefuroxime iv 1500 mg single dose

Transurethral resection of bladder tumour

cefuroxime iv 1500 mg single dose

Ureterorenoscopy (URS)

≥ 18 years

Indications: Prosthesis and sling surgery

Дозування Ремарки
cefuroxime iv 1500 mg single dose

+

metronidazole iv single dose

AMS-prosthesis, Argus male sling, Proact para-urethral balloon

 

extended prophylaxis 5 days amoxicillin/clavulanic acid 3 times daily 500/125 mg, or in case of allergy clindamycin 3 times daily 600 mg

cefuroxime iv 1500 mg single dose

Neurostimulator

cefuroxime iv 1500 mg single dose

Testicular prosthesis

cefuroxime iv 1500 mg single dose

Sling (female)

TVT, TVT-O, (no antibiotics for primary placement)

 

if antibiotics: 3 days extended prophylaxis ciprofloxacin 2x daily 500 mg

cefuroxime iv 1500 mg single dose

Penile prosthesis

cefuroxime iv 1500 mg single dose

metronidazole iv 500 mg single dose

Urethroplasty

no extended prophylaxis

cefuroxime iv 1500 mg single dose

Placement of Interstim

extended prophylaxis 5 days amoxicillin/clavulanic acid 3 times daily 500/125 mg, or in case of allergy clindamycin 3 times daily 600 mg

≥ 18 years

Indications: Penis/scrotum surgery

Дозування Ремарки

Varicocele, vasectomy, frenulotomy, circumcision, orchidectomy

NO PROPHYLAXIS

≥ 18 years

Indications: Other surgery

Дозування Ремарки

Extracorporeal shock wave lithotripsy (ESWL)

NO PROPHYLAXIS

Comments

Cefuroxime repeat dosing if operative duration >3 hours and if blood loss >1500 ml

Piperacillin/tazobactam repeat dosing for operative duration >2 hours and for blood loss > 1500 ml.

As operative duration for radical cystectomy is always >2 hours, start the second dose after 1–1.5 hours.

The use of extended antibiotic prophylaxis after prosthesis surgery is not recommended by the antibiotic committee. However, extended antibiotic prophylaxis is applied by the urology department. This is in consultation with the antibiotic committee. Data are currently being generated together and the evidence for extended prophylaxis is being examined. Until then, the departmental protocol remains in force.