Antimicrobial prescribing: NHS Lothian
Blood cultures X 2 sets
Imaging and sampling (biopsy/surgical sampling)
Post surgical deep spinal infection
Do not start antibiotic therapy until samples obtained if clinically stable.
| Recommended antibiotic |
Ceftazadime 2g IV 8 hourly PLUS Vancomycin IV (use NHS Lothian Calculator on AMT intranet page); aim trough levels 15-20mg/L |
| Severe penicillin allergy or previous MRSA |
Vancomycin IV (use NHS Lothian Calculator on AMT intranet page); aim trough levels 15-20mg/L PLUS Ciprofloxacin 400mg IV 8 hourly* |
*Avoid fluoroquinolones if taking steroids and the elderly.
Review MHRA Quinolone Warning before prescribing.
If an alternative agent is required please contact microbiology
Discuss with microbiology and neurosurgery
Usually 6-12 weeks duration, longer duration may be required if metalwork retained
Causative organisms include Staphylococcus, Gram-negative bacilli.