BACKGROUND: Although appropriate perioperative antibiotic prophylaxis has significantly reduced wound infection rates in clean-contaminated head and neck surgical procedures, controversy still remains regarding the optimal antibiotic regimen. METHODS: In this prospective, double-blind clinical trial, 159 patients were randomized to receive amoxicillin-clavulanate, clindamycin plus gentamicin, or cefazolin intravenously up to 1/2 hour before surgery and at 6-hour intervals for an additional three doses. RESULTS: An overall wound infection rate of 23% was observed. Thirteen (22.8%) infections occurred in the amoxicillin-clavulanate-treated group, 11 (21.2%) in the clindamycin plus gentamicin-treated group, and 13 (26%) in the cefazolin-treated group, which was not statistically significant. Only prior medical illnesses, such as chronic obstructive pulmonary disease and diabetes mellitus, correlated with an increased wound infection rate (p = 0.018). CONCLUSIONS:Amoxicillin-clavulanate, clindamycin plus gentamicin, and cefazolin seem to have similar efficacy when administered prophylactically in clean-contaminated head and neck surgical procedures.
RCT Entities:
BACKGROUND: Although appropriate perioperative antibiotic prophylaxis has significantly reduced wound infection rates in clean-contaminated head and neck surgical procedures, controversy still remains regarding the optimal antibiotic regimen. METHODS: In this prospective, double-blind clinical trial, 159 patients were randomized to receive amoxicillin-clavulanate, clindamycin plus gentamicin, or cefazolin intravenously up to 1/2 hour before surgery and at 6-hour intervals for an additional three doses. RESULTS: An overall wound infection rate of 23% was observed. Thirteen (22.8%) infections occurred in the amoxicillin-clavulanate-treated group, 11 (21.2%) in the clindamycin plus gentamicin-treated group, and 13 (26%) in the cefazolin-treated group, which was not statistically significant. Only prior medical illnesses, such as chronic obstructive pulmonary disease and diabetes mellitus, correlated with an increased wound infection rate (p = 0.018). CONCLUSIONS:Amoxicillin-clavulanate, clindamycin plus gentamicin, and cefazolin seem to have similar efficacy when administered prophylactically in clean-contaminated head and neck surgical procedures.
Authors: Nicolas Penel; Charles Fournier; Micheline Roussel-Delvallez; Danièle Lefebvre; Ahmed Kara; Yann Mallet; Jean-Charles Neu; Jean-Louis Lefebvre Journal: Support Care Cancer Date: 2004-09 Impact factor: 3.603
Authors: Mohammad Taghy; Khorsandi Ashtiani; Mohammad Sadeghi; Babak Saedi; Gilda Givechi Journal: Indian J Otolaryngol Head Neck Surg Date: 2010-06-04
Authors: Vincent Vander Poorten; Saartje Uyttebroek; K Thomas Robbins; Juan P Rodrigo; Remco de Bree; Annouschka Laenen; Nabil F Saba; Carlos Suarez; Antti Mäkitie; Alessandra Rinaldo; Alfio Ferlito Journal: Adv Ther Date: 2020-03-05 Impact factor: 3.845