38. Vascular Surgery

Procedure	Antibiotic	Dose	Route	Dosing Interval	Dosing Interval
Open AAA / aortic reconstruction	Cefuroxime and metronidazole	Cefuroxime and vancomycin	IV	At induction	2 post operative doses over 12 to 24 hours
Endovascular aortic procedures	Cefuroxime	1.5g	IV	At induction	2 post operative doses over 12 to 24 hours
Carotid surgery	Cefuroxime	1.5g	IV	At induction	2 post operative doses over 12 to 24 hours
Other arterial reconstructions (without presence of sepsis)	Cefuroxime	1.5g	IV	At induction	2 post operative doses over 12 to 24 hours
Amputations and arterial reconstruction in patients with sepsis	Cefuroxime and metronidazole	1.5g 500mg	IV	At induction	Continue treatment for 5 days (Regime may be modified based on culture / sensitivities
Varicose vein surgery	PROPHYLAXIS NOT RECOMMENDED
Patients deemed high risk of MRSA wound / graft infection (positive screen)	Cefuroxime and vancomycin	1.5g 1g	IV	At induction	Continue vancomycin for 48 hours following a graft. Consult microbiology for further advice

Note: In penicillin / beta-lactam allergic (anaphylaxis) patients give gentamicin as an alternative to cefuroxime