Antimicrobial prophylaxis of infections in head and neck cancer surgery.
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.
D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D001424:Bacterial Infections / Q000517:prevention & control*; D002981:Clindamycin / Q000008:administration & dosage; D002986:Clinical Trials as Topic; D004311:Double-Blind Method; D004338:Drug Combinations; D004359:Drug Therapy, Combination; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D009428:Netilmicin / Q000008:administration & dosage; D010406:Penicillins / Q000008:administration & dosage; D011292:Premedication; D013530:Surgical Wound Infection / Q000517:prevention & control*
D000900:Anti-Bacterial Agents; D004338:Drug Combinations; D010406:Penicillins; D002981:Clindamycin; D009428:Netilmicin