31. ENT Surgery

Procedure

Antibiotic

Dose

Route

Dosing Interval

Comment

Tonsillectomy

PROPHYLAXIS IS NOT RECOMMENDED

Nose/sinus surgery

Head & Neck clean

Head & Neck

(contaminated/clean- contaminated)

Amoxicillin and Metronidazole

500mg

500mg

IV

At induction

If the patient has received an antibiotic during the 2 weeks prior to surgery, prescribe metronidazole 500mg IV STAT plus an appropriate antibiotic from a different class. E.g. If previously taking a beta-lactam antibiotic, prescribe a macrolide.

Note: Contaminated/clean-contaminated head and neck surgery is where mucosal breaching has occurred or a radical neck dissection (e.g. for a carcinoma not a thyroidectomy).

Procedure	Antibiotic	Dose	Route	Dosing Interval	Comment
Tonsillectomy	PROPHYLAXIS IS NOT RECOMMENDED
Nose/sinus surgery
Head & Neck clean
Head & Neck (contaminated/clean- contaminated)	Amoxicillin and Metronidazole	500mg 500mg	IV	At induction	If the patient has received an antibiotic during the 2 weeks prior to surgery, prescribe metronidazole 500mg IV STAT plus an appropriate antibiotic from a different class. E.g. If previously taking a beta-lactam antibiotic, prescribe a macrolide.