35. Orthopaedic Surgery

Procedure	Antibiotic	Dose	Route	Dosing Interval	Comment
Total hip replacement	Cefuroxime	1.5g	IV	Give at induction and 750mg given 8,16 hours post operatively	Prophylactic antibiotics should be given to anybody receiving an implant (e.g. joint replacement, metal plate, screws or artificial material)
Prosthetic knee joint replacement	Cefuroxime	1.5g	IV	Give at induction and 750mg given 8,16 hours post operatively
Spinal surgery	Cefuroxime	1.5g	IV	At induction
Closed fracture fixation (Non hip)	Cefuroxime	1.5g	IV	At induction- no post operative doses	With K wires
Hip fracture repair +/-hemiarthroplasty	Cefuroxime	1.5g	IV	Give at induction and 750mg given 8,16 hours post operatively
Insertion of prosthetic device	Cefuroxime	1.5g	IV	Give at induction and 750mg given 8,16 hours post operatively
Surgery without prosthetic device if no infection present	PROPHYLAXIS NOT RECOMMENDED

Note 1: Clean procedures require no prophylactic antibiotics unless wound exposure > 2 hours.
Note 2: For removal of infected devices/joints continue antibiotic treatment until after surgery.
Note 3 : If the patient has a history of penicillin anaphylaxis contact microbiology.