REKOMENDASI ANTIBIOTIK PADA PROFILAKSIS BEDAH

Rekomendas Indikasi Antibiotik

Prosedur Bedah
i Profilaksi
Intracranial
 Craniotomy A Recommended
 Cerebrospinal fluid (CSF)shunt A Recommended
 Spinal surgery A Recommended
Ophtalmic
 Spinal surgery A Highly recommended
 Glaukoma atau corneal grafts B Recommended
 Operasi lakrimal C Recommended
 Penetrating eye injury B Recommended
Facial
 Open reduction dan internal fixation
A Recommended
compound mandibular fractures
 Intraoral bone grafting Procedures B Recommended
 Orthognathic surgery A Recommended
 Facial surgery (clean) A Not Recommended
 Facial plastic surgery (with implant) B Should be considered
Ear, nose and throat
 Ear surgery (clean/clean-contaminated) A Not Recommended
 Routine nose, sinus and endoscopic
A Not Recommended
sinus surgery
Lama pemberian
 Complex septorhinoplasty
 (including
A antibiotic tidak boleh dari
grafts)

24 jam
 Tonsillectomy A Not Recommended
 Adenoidectomy (by curettage) A Not Recommended
 Grommet insertion B Recommended
 Head and neck
 Head and neck surgery (clean, benign) D Not Recommended
 Head and neck surgery (clean,
C Should be considered
malignant; neck dissection)
 Head and neck surgery
A Recommended
(contaminated/cleancontaminated)
Thorax
 Breast cancer surgery A Should be considered
 Breast reshaping procedures C Should be considered
 Breast surgery with implant Recommended
C
(reconstructive or aesthetic)
 Cardiac pacemaker insertion A Recommended
 Open heart surgery C Recommended
 Pulmonary resection A Recommended
Upper Gastrointestinal
 Rekomendas Indikasi Antibiotik
Prosedur Bedah
i Profilaksi
 Oesophageal surgery D Recommended
 Stomach and duodenal surgery A Recommended
 Gastric bypass surgery D Recommended
 Small intestine surgery D Recommended
Hepatobiliary
 Bile duct surgery A Recommended
 Pancreatic surgery B Recommended
 Liver surgery B Recommended
 Gall bladder surgery (open) A Recommended
 Gall bladder surgery (laparoscopic) A Not Recommended
Lower Gastrointestinal
 Appendicectomy A Highly Recommended
 Colorectal surgery A Highly Recommended
Abdomen
 Hernia repair-groin (inguinal/femoral Not Recommended
A
with or without mesh)
 Hernia repair-groin (laparoscopic with Not Recommended
B
or without mesh)
 Hernia repair (incisional with or without Not Recommended
C
mesh)
 Open/laparoscopic surgery with mesh Not Recommended
B
(eg gastric band or rectoplexy)
 Diagnostic endoscopic procedures D Not Recommended
 Therapeutic endoscopic procedures
(endoscopic retrograde cholangio Should be considered in
D
pancreatography and percutaneous high risk patient
endoscopic gastrostomy)
Spleen
Not Recommended
 Splenectomy - Should be considered in
high risk patient
Gynecological
 Abdominal hysterectomy A Recommended
 Vaginal hysterectomy A Recommended
 Caesarean section A Highly Recommended
 Assisted delivery A Not Recommended
Recommended (grade 3
 Perineal tear D
& 4)
Abdomen Gynecological
 Manual removal of the placenta D Should be considered
 Induced abortion A Highly Recommended
 Evacuation of incomplete miscarriage A Not Recommended
 Intrauterine contraceptive device Not Recommended
A
(IUCD) insertion
 Rekomendas Indikasi Antibiotik
Prosedur Bedah
i Profilaksi
Urogenital
 Transrectal prostate biopsy A Recommended
 Shock wave lithotripsy A Recommended
Recommended untuk
pasien dengan batu > 20
 Percutaneous nephrolithotomy B
mm atau dengan
pervicalyceal dilatation
 Endoscopic ureteric stone
B Recommended
fragmentation/removal
 Transurethral resection of the prostate A Highly Recommended
 Abdomen Urogenital
 Transurethral resection of
 bladder
D Not Recommended
tumours

 Radical cystectomy - Recommended
Limb
 Arthroplasty B Highly Recommended
 Open fracture A Highly Recommended
 Open surgery for closed fracture A Highly Recommended
 Hip fracture A Highly Recommended
 Orthopaedic surgery (without implant) D Not Recommended
 Lower limb amputation A Recommended
 Vascular surgery (abdominal and lower Recommended
A
limb arterial reconstruction)
 Soft tissue surgery of the hand - Should be considered
Non-operative intervention
 Intravascular catheter insertion:

D Not Recommended
− non-tunnelled central venous
catheter (CVC)
A Not Recommended
− tunnelled CVC
General
 Clean-contaminated procedures –
D Recommended
where no specific evidence is available
 Insertion of a prosthetic device or
implant – where no specific evidence is D Recommended
available
Head and Neck
 Craniotomy B Recommended
 CSF shunt A Recommended
 Spinal surgery B Recommended
 Tonsillectomy - Not Recommended
 Cleft lip and palate -
 Adenoidectomy (by curettage) A Not Recommended
 Grommet insertion B Recommended
 Rekomendas Indikasi Antibiotik
Prosedur Bedah
i Profilaksi
Thorax
 Open heart surgery D Recommended
 Closed cardiac procedures (clean) - Not Recommended
 Interventional cardiac catheter device
- Highly Recommended
placement
Gastrointestinal
 Appendicectomy A Highly Recommended
 Colorectal surgery B Highly Recommended
 Insertion of percutaneous endoscopic
B Recommended
gastrostomy (PEG)
 Splenectomy - Not Recommended
Urogenital
 Circumcision (routine elective) - Not Recommended
Should be considered
 Hypospadias repair B
(sampai kateter dilepas)
 Hydrocoeles/hernia repair C Not Recommended
 Shock wave lithotripsy B Recommended
 Percutaneous nephrolithotomy C Recommended
 Endoscopic ureteric stone Recommended
C
fragmentation/removal
 Cystoscopy - Not Recommended
 Nephrectomy - Not Recommended
 Pyeloplasty - Recommended
 Surgery for vesicoureteric reflux Recommended
-
(endoscopic or open)
Non-operative interventions
 Intravascular catheter insertion:

− non-tunnelled central venous D Not Recommended
catheter (CVC) D Not Recommended
− tunnelled CVC
General
 Clean-contaminated procedures–where Recommended
D
no specific evidence is available
 Insertion of a prosthetic device or Recommended
implant–where no specific evidence is D
available