Metronidazole in head and neck surgery--the effect of lengthened prophylaxis.
Previous studies of antibiotic prophylaxis have shown that treatment for 24 hours has been beneficial for head and neck surgery and that longer periods of antibiotic therapy have not improved results. Metronidazole (Flagyl), unlike other antibiotics tested, has been shown to be effective in an experimental abscess, even if treatment is begun up to 120 hours after administration of inoculum. This article presents a prospective, randomized, multifactorial study comparing a brief vs. a prolonged duration of metronidazole and cefazolin prophylaxis in 50 consecutive patients with a head and neck cancer undergoing operation. Patients receiving 2 days vs. 7 or more days of antibiotic prophylaxis were compared. Statistical analysis of data demonstrated a striking reduction in severity of wound complications and a reduced incidence of wound infections in the group treated with 7 or more days of antibiotic prophylaxis.
Sawyer
R
R
Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, MD 21205.
Cozzi
L
L
Rosenthal
D I
DI
Maniglia
A J
AJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002437:Cefazolin / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006257:Head / Q000601:surgery*; D006801:Humans; D008297:Male; D008795:Metronidazole / Q000008:administration & dosage / Q000627:therapeutic use*; D008875:Middle Aged; D009333:Neck / Q000601:surgery*; D011446:Prospective Studies; D012307:Risk Factors; D013524:Surgical Flaps; D013530:Surgical Wound Infection / Q000517:prevention & control*; D013997:Time Factors
D008795:Metronidazole; D002437:Cefazolin