Post-operative wound infection

Micro-organism

Staph. aureus, anaerobes

Duration

10 - 14 days

Notes
  • Take appropriate specimens before starting therapy, consult dermatologist and medical microbiologist for patients with severe or recurrent infections
  • Consider the necessity for surgical intervention, tetanus prophylaxis and topical cleaning
  • Chronic wounds such as pressure sores and leg ulcers do not require antibiotics unless there is clinical evidence of infection eg cellulitis, discharge or acute pain
  • Route of administration is dependent on the severity of infection and ability of patient to take medication orally.
  • If collection present will require surgical drainage
'Clean' sites (excluding abdominal, female genital tract, head & neck)

IV /Oral Flucloxacillin 500mg -1g 6 hourly

'Clean' sites (excluding abdominal female genital tract, head & neck) - Penicillin Allergy

Vancomycin IV as per guideline

Use preferred calculator on Hospital portals page [intranet access only] or calculator on app for intermittent dosing.

Switch to

Oral Co-trimoxazole 960mg 12 hourly 

'Dirty' sites - abdominal, female genital tract, head & neck

If IV required:

IV Co-trimoxazole* 960mg 12 hourly

+/- IV Metronidazole 500mg 8 hourly

 

Switch to

oral Co-trimoxazole 960mg 12 hourly

+/- oral Metronidazole 400mg 8 hourly 

*If IV Co-trimoxazole not available or unsuitable use IV Co-amoxiclav 1.2g 8 hourly

'Dirty sites' - abdominal, female genital tract, head & neck - Second line

If IV Co-trimoxazole not available or unsuitable

IV Co-amoxiclav 1.2g 8 hourly

 

OR if penicillin allergic

IV Clindamycin 600mg 8 hourly