Publication | Closed Access
Antimicrobial prophylaxis of infections in head and neck cancer surgery.
55
Citations
0
References
1983
Year
Antibiotic AdjuvantSurgeryAntimicrobial ChemotherapyTreatment ResistanceDrug ResistanceSurgical Site InfectionsAntimicrobial StewardshipHealthcare-associated InfectionAntimicrobial TherapyInfection ControlNeck OncologyAntimicrobial ResistanceNeck TumorsHospital EpidemiologyHealth SciencesHead And Neck SurgeryAntimicrobial PharmacokineticsPatients Undergoing SurgeryClinical MicrobiologyNeck Cancer SurgeryAntimicrobial SusceptibilityAntibioticsHead And Neck CancerAntimicrobial PharmacodynamicsMedicineProsthetic Joint InfectionsProlonged Prophylaxis
429 patients undergoing surgery for head and neck tumors were involved in 4 consecutive, randomized clinical trials of antimicrobial prophylaxis: placebo versus ampicillin plus cloxacillin (2 g of each daily for 6 days), ticarcillin (5 g X 12, 8-hourly) versus carbenicillin (10 g X 12, 8-hourly) short carbenicillin prophylaxis (1 day) versus prolonged carbenicillin prophylaxis (4 days) and clindamycin (900 mg, 4 daily doses) versus clindamycin plus netilmicin (90 mg, 4 daily doses). Aerobic gram-negative strains were the microorganisms most frequently isolated either from colonized or infected wounds. The first controlled study showed a significant decrease in the rate of postoperative bacterial infections in the treated group as compared to the placebo-treated group (p less than 0.05). In all the subsequent treatment groups, postoperative infection rates ranged from 6 to 16%. Short prophylaxis was as effective as prolonged prophylaxis. A regimen directed mainly against anaerobes (clindamycin) did not seem of less value than broad spectrum regimens covering most aerobic gram-negative bacilli.