title: Nonwound infections following head and neck oncologic surgery.
abstract: Little information exists regarding the comorbidity of postoperative nonwound infections (NWIs) in patients with head and neck cancer. Prospectively, 225 patients were randomized in a double-blind fashion to receive either clindamycin or ampicillin sodium/sulbactam sodium for prevention of postoperative wound infection. Of the 113 patients receiving clindamycin, 14 developed nonwound infections, compared with 10 of 112 patients receiving ampicillin/sulbactam. A single site of nonwound infection occurred in 21 patients, and 2 sites occurred in 3 patients. The majority of infections were pulmonary (22), followed by urinary tract (3), septic phlebitis (1), and acute sinusitis (1). Gram-negative organisms were isolated more frequently among patients on clindamycin (18) versus ampicillin/sulbactam (6) (P = .014). Risk factors for pulmonary nonwound infection included: longer surgery, a greater than 70 packs per year smoking history, blood transfusion, and hypoalbuminemia (P < .05). Nonwound infections produce significant postoperative morbidity and the predominance of gram-negative organisms isolated from these infections has therapeutic implications.
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: P
authors.initials: P
authors.lastname: Hankins
authors.forename: B
authors.initials: B
authors.lastname: Rosenbaum
authors.forename: I
authors.initials: I
authors.lastname: Raad
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000667:Ampicillin / Q000008:administration & dosage / Q000627:therapeutic use; D016470:Bacteremia / Q000209:etiology / Q000517:prevention & control*; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D002981:Clindamycin / Q000627:therapeutic use; D004311:Double-Blind Method; D004338:Drug Combinations; D005260:Female; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000382:microbiology; D011183:Postoperative Complications / Q000517:prevention & control*; D011446:Prospective Studies; D012141:Respiratory Tract Infections / Q000209:etiology / Q000517:prevention & control*; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D013407:Sulbactam / Q000008:administration & dosage / Q000627:therapeutic use; D014552:Urinary Tract Infections / Q000209:etiology / Q000517:prevention & control*; D014946:Wound Infection / Q000209:etiology
chemical_list: D004338:Drug Combinations; D002981:Clindamycin; D000667:Ampicillin; D013407:Sulbactam