Editing Antibiotic Prophylaxis (section)

== Recommended Prophylaxis ==
{| class="wikitable"
|+
!Procedure
!Antibiotic
!Alternative
!Duration
|-
|'''<span style="color:#ff0000">Cystoscopy with minor manipulation'''
|'''<span style="color:#ff0000">If risk-factors'''
'''<span style="color:#ff0000">TMP-SMX OR'''

'''<span style="color:#ff0000">Amoxicillin/Clavulanate'''
|'''1st/2nd generation cephalosporin OR'''
'''Aminoglycoside +/- Ampicillin OR''' 

'''Aztreonam +/- Ampicillin'''
|'''Single dose'''
|-
|'''<span style="color:#ff0000">Transurethral cases with resection'''
|'''<span style="color:#ff0000">Cefazolin OR'''
'''<span style="color:#ff0000">TMP-SMX'''
|'''Amoxicillin/Clavulanate OR'''
'''Aminoglycoside +/- Ampicillin OR''' 

'''Aztreonam +/- Ampicillin'''
|'''Single dose'''
|-
|'''<span style="color:#ff0000">Transrectal prostate biopsy'''
|'''<span style="color:#ff0000">Fluoroquinolone OR'''
'''<span style="color:#ff0000">1st/2nd generation cephalosporin +/- aminoglycoside OR'''

'''<span style="color:#ff0000">3rd generation cephalosporin'''

|'''Aztreonam'''
'''May need infectious disease consultation'''
|'''Single dose'''
|-
|'''<span style="color:#ff0000">Percutaneous renal surgery'''
|'''<span style="color:#ff0000">1st/2nd generation cephalosporin OR'''
'''<span style="color:#ff0000">Aminoglycoside and clindamycin OR'''

'''Aminoglycoside and metronidazole OR'''

'''Aztreonam and metronidazole OR'''

'''Aztreonam and clindamycin'''
|'''Ampicillin/sublactan'''
|'''≤24 hours'''
|-
|'''<span style="color:#ff0000">Ureteroscopy'''
|'''<span style="color:#ff0000">1st/2nd generation cephalosporin OR'''
'''<span style="color:#ff0000">TMP-SMX'''

|'''Aminoglycoside +/- Ampicillin OR''' 
'''Aztreonam +/- Ampicillin OR'''

'''Amoxicillin/Clavulanate'''
|'''Single dose'''
|-
|'''<span style="color:#ff0000">Open, laparoscopic, or robotic surgery without entry into urinary tract'''
|'''<span style="color:#ff0000">Cefazolin'''
|'''Clindamycin'''
|'''Single dose'''
|-
|'''<span style="color:#ff0000">Open, laparoscopic, or robotic surgery involving controlled entry into urinary tract'''
|'''<span style="color:#ff0000">Cefazolin OR'''
'''<span style="color:#ff0000">TMP-SMX'''
|'''Ampicillin/Sublactam OR''' 
'''Aminoglycoside and metronidazole OR'''

'''Aztreonam and metronidazole OR'''

'''Aminoglycoside and clindamycin OR''' 

'''Aztreonam and Clindamycin'''
|'''Single dose'''
|-
|'''<span style="color:#ff0000">Open, laparoscopic, or robotic surgery involving small bowel'''
|'''<span style="color:#ff0000">Cefazolin'''
|Clindamycin and aminoglycoside OR 
Cefuroxime (2nd generation cephalosporin) OR

Aminopenicillin combined with a β- lactamase inhibitor and Metronidazole (optional)
|'''Single dose'''
|-
|'''<span style="color:#ff0000">Implanted prosthetic devices (AUS, IPP, sacral neuromodulators)'''
|'''<span style="color:#ff0000">Aminoglycoside and 1st/2nd gen cephalosporin OR'''
'''<span style="color:#ff0000">Aminoglycoside and Vancomycin OR''' 

'''Aztreonam and 1st/2nd generation cephalosporin OR'''

'''Aztreonam and Vancomycin'''
|'''Aminopenicillin OR'''
'''B-lactamase inhibitor (including ampicillin/sublactan, ticarcillin, tazobactam)'''
|'''≤24 hours'''
|}

=== Typical doses[https://anesthesia.bidmc.harvard.edu/ADEL/Documents/uro_prophy.pdf §][https://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/resources/appendix+16+urological+surgery §][https://www.med.umich.edu/asp/pdf/surgical_prophylaxis/surg-ppx_Guideline.pdf §][https://www.mdanderson.org/content/dam/mdanderson/documents/for-physicians/algorithms/clinical-management/clin-management-surgical-antibiotic-prophylaxis-adult-web-algorithm.pdf §] ===

* '''TMP/SMX: 800 mg of sulfamethoxazole and 160 mg of trimethorprim PO x 1 dose'''
*'''1st generation cephalosporin: cefazolin 2gm IV x 1 dose'''
*'''3rd generation cephalosporin: cetriaxone 2g IV x 1 dose'''
* '''Clindamycin 600mg IV x 1 dose'''
* '''Fluoroquinolone: levofloxacin 500mg PO x 1 dose OR ciprofloxacin 500 mg PO x 1 dose'''
* '''Aminoglycoside: gentamicin 2mg/kg IV x 1 dose'''
* '''Vancomycin 1mg IV x 1 dose'''
* '''Metronidazole 500mg IV x 1 dose'''
* '''Intraoperative redosing if required'''
** '''Cefazolin 2gm IV q4h'''
** '''Clindamycin 600mg IV q8h'''
** '''Gentamicin 1mg/kg q8h'''
** '''Metronidazole 500mg IV q6h'''

*