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Table 1 Antibiotic prophylaxis for heart surgery – Coronary Artery Bypass Graft & Valve surgery as per Hospital Guidelines. GFR: Golerular Filtration Rate

From: The impact of closed incision negative pressure therapy on prevention of median sternotomy infection for high risk cases: a single centre retrospective study

Patients Antibiotics
All Patients Flucloxacillin 1 g IV at induction followed by 1 g IV after bypass (e.g. at skin closure) and then 6, 12 and 18 h later and then STOP plus Gentamicin 5 mg/kg IV (maximum 480 mg) at induction only
Note: The administration of a 2nd (or sometimes 3rd) intra-operative dose of flucloxacillin
will depend on factors such as the length of operation and the type of bypass used and
is therefore at the discretion of the anaesthetist/surgeon to be adjusted according to
circumstances
Penicillin allergy Teicoplanin 400 mg IV (use 600 mg in those ≥90 kg) at induction with a subsequent dose at 12 h and then STOP plus Gentamicin 5 mg/kg IV (maximum 480 mg) at induction only
Renal impairment Flucloxacillin 1 g IV: No adjustment required
Gentamicin: 2 mg/kg if GFR < 50 ml/min
Teicoplanin 400 mg IV: No adjustments required for single dose and if GFR > 60 ml/min. If GFR ≤60 ml/min – A 2nd dose within 24 h is NOT required