title: Ampicillin-sulbactam vs clindamycin in head and neck oncologic surgery. The need for gram-negative coverage.
abstract: This study was undertaken to assess whether gram-negative antimicrobial coverage is required in patients undergoing head and neck oncologic surgery. Ampicillin sodium-sulbactam sodium and clindamycin phosphate were compared in a prospective, randomized, parallel, double-blind trial of 212 patients undergoing head and neck procedures involving clean-contaminated wounds. Both antibiotics were given up to 1 hour before surgery and continued at 6-hour intervals after surgery for an additional eight doses. Fourteen infections occurred in the ampicillin-sulbactam-treated group (13.3%) and 29 infections in the clindamycin-treated group (27.1%). From patients receiving clindamycin, 29 gram-negative organisms were isolated, compared with six from those patients receiving ampicillin-sulbactam. This finding supports the need for gram-negative coverage in patients undergoing clean-contaminated head and neck oncologic surgery.
authors.affiliation: Department of Head and Neck Surgery, University of Texas M.D. Anderson Cancer Center, Houston 77030.
authors.forename: R S
authors.initials: RS
authors.lastname: Weber
authors.forename: I
authors.initials: I
authors.lastname: Raad
authors.forename: R
authors.initials: R
authors.lastname: Frankenthaler
authors.forename: P
authors.initials: P
authors.lastname: Hankins
authors.forename: R M
authors.initials: RM
authors.lastname: Byers
authors.forename: O
authors.initials: O
authors.lastname: Guillamondegui
authors.forename: P
authors.initials: P
authors.lastname: Wolf
authors.forename: T
authors.initials: T
authors.lastname: Smith
authors.forename: H
authors.initials: H
authors.lastname: Goepfert
mesh_terms: D000328:Adult; D000667:Ampicillin / Q000627:therapeutic use*; D002981:Clindamycin / Q000627:therapeutic use*; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D006258:Head and Neck Neoplasms / Q000601:surgery; D006801:Humans; D013407:Sulbactam / Q000627:therapeutic use*; D013530:Surgical Wound Infection / Q000517:prevention & control*
chemical_list: D002981:Clindamycin; C035444:sultamicillin; D000667:Ampicillin; D013407:Sulbactam