Nephrostomy tube change - high risk
advanced age
anatomical abnormality of urinary tract
immunodeficiency/chronic corticosteroid use
prolonged hospitalization
externalized catheter
prolonged indwelling catheter
poor nutritional status
smoking
Note: If positive urine culture pre-operatively, institute treatment according to culture and susceptibility results.
Common Pathogens
Enterobacteriaceae
Pseudomonas spp
Enterococcus spp
| Regimen(s) of Choice See General Principles and Pre-Op Antibiotic Administration and Intraoperative Antibiotic Administration | ||
|---|---|---|
| Oral regimens: (give 1-2h pre-op) | ||
| Ciprofloxacin | 500mg PO | x 1 pre-op dose |
| or | ||
| Co-trimoxazole | 1 DS tablet PO | x 1 pre-op dose |
| or | ||
| Parenteral regimens: | ||
| Ceftriaxone | 1g IV | x 1 pre-op dose |
| or | ||
| Gentamicin | 1.5mg/kg IV | x 1 pre-op dose |
| Alternative Regimens if allergy to cefazolin, or severe non-IgE-mediated reaction to any β-lactam (interstitial nephritis, hepatitis, hemolytic anemia, serum sickness, severe cutaneous reactions [e.g. SJS, TEN, DRESS]) | ||
|---|---|---|
| Oral regimens: (give 1-2h pre-op) | ||
| Ciprofloxacin | 500mg PO | x 1 pre-op dose |
| or | ||
| Co-trimoxazole | 1 DS tablet PO | x 1 pre-op dose |
| or | ||
| Parenteral regimen: | ||
| Gentamicin | 1.5mg/kg IV | x 1 pre-op dose |