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Recommendations

≥ 18 years
Дозування Ремарки
flucloxacillin IV loading dose 1 g, 6 g continuous over 24 hours

or

cefazolin IV loading dose 1 g, 6 g continuous over 24 hours

Post-operatively pending culture results.

 

If continuous infusion is not possible: then flucloxacillin 6 times daily 1 gram or cefazolin 3 times daily 2 grams

flucloxacillin IV loading dose 2 g, 12 g continuous over 24 hours

+

ceftazidime IV 2000 mg three times daily

When severely ill, with a haematogenous source and/or recent cultures showing gram-negative pathogens (both in the setting of revision and no revision)

in consultation with the medical microbiologist/infectiologist

teicoplanin IV

In the case of revision surgery

post-operatively pending culture results

For loading and maintenance dosing, see teicoplanin

Comments

Goal: surgical debridement with the aim of retaining the prosthesis/osteosynthesis material (DAIR: debridement, antibiotics, implant retention).

Adjust antibiotics according to culture results in consultation with the microbiologist/infectiologist.

In recurrent infection of an in situ prosthesis/osteosynthesis material: consult the microbiologist/infectiologist regarding antibiotic management based on previous cultures.

Each patient should, in principle, be discussed at the multidisciplinary orthopaedics-infection meeting on Wednesday mornings. Register via the orthopaedics ward doctor.

Consider postoperative wound infection as infection of prosthetic material