Renal Transplant Surgery in Adults - Guideline for Antimicrobial Prophylaxis

Publication: 01/03/2010  --
Last review: 16/11/2021  
Next review: 16/11/2024  
Clinical Guideline
CURRENT 
ID: 1868 
Approved By: Improving Antimicrobial Prescribing Group 
Copyright© Leeds Teaching Hospitals NHS Trust 2021  

 

This Clinical Guideline is intended for use by healthcare professionals within Leeds unless otherwise stated.
For healthcare professionals in other trusts, please ensure that you consult relevant local and national guidance.

GUIDELINE FOR ANTIMICROBIAL PROPHYLAXIS RENAL TRANSPLANT SURGERY IN ADULTS

RECOMMENDED ROUTINE PROPHYLAXIS OPTIONS1

Procedure or situation

Antimicrobial dose/route
Give within 1 hour of procedure starting unless otherwise stated
All single doses unless stated otherwise.

Routine2

MRSA Risk3

Penicillin allergy

Renal transplant recipient surgery (living or deceased donor).

Co-Amoxiclav (Amoxicillin-Clavulanate)Description: electronic Medicines Compendium information on Co-Amoxiclav (Amoxicillin-Clavulanate) IV 1.2g

Co-Amoxiclav  IV 1.2g

AND

Teicoplanin 400mg IV

Ciprofloxacin  IV 400mg

AND 

Teicoplanin  IV 400mg

Donor nephrectomy

FlucloxacillinDescription: electronic Medicines Compendium information on Flucloxacillin1g IV
AND
Gentamicin IV 2mg/Kg IBW 

TeicoplaninDescription: electronic Medicines Compendium information on Teicoplanin400mg IV
AND
Gentamicin IV 2mg/Kg IBW  

TeicoplaninDescription: electronic Medicines Compendium information on Teicoplanin400mg IV  
AND
Gentamicin IV 2mg/Kg IBW  

FOOTNOTES

  1. The 2014 Scottish Intercollegiate Guideline Network (SIGN) surgical prophylaxis guidelines specifically exclude transplant surgery (2). There are no British Transplant Society or CDC guidelines for this area. The choice of agents was initially discussed by the Renal Transplant Service Team and Microbiology in 2009 and last reviewed in 2017.
  2. For all patients, results from any recent urine isolates should be used to inform the choice of prophylaxis (i.e. Co-Amoxiclav Description: electronic Medicines Compendium information on Co-Amoxiclav (Amoxicillin-Clavulanate) would not be the most appropriate agent where a patient had a recent urinary ESBL E. coli isolated - prophylaxis should be discussed with the Microbiology service).
  3. MRSA risk = previous MRSA infection or known colonisation

Provenance

Record: 1868
Objective:
Clinical condition:

Renal transplant surgery in adults

Target patient group: All patients undergoing renal transplant surgery
Target professional group(s): Pharmacists
Secondary Care Doctors
Adapted from:

Evidence base

  • Anesi JA et al. Perioperative Antibiotic Prophylaxis to Prevent Surgical Site Infections in Solid Organ Transplantation. Transplantation. 2017. Prior to publication.
  • SIGN. Antibiotic Prophylaxis in Surgery. Scottish Intercollegiate Guideline Network Publication Number 104. Edinburgh; 2014

Approved By

Improving Antimicrobial Prescribing Group

Document history

LHP version 2.0

Related information

Not supplied

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