Prophylaxis with cefazolin plus clindamycin in clean-contaminated maxillofacial surgery.
OBJECTIVE
Infections after maxillofacial surgery are usually due to aerobic and anaerobic gram-positive cocci and gram-negative bacilli. Various antimicrobials, including cephalosporins, beta-lactams/beta-lactamase inhibitors, aminoglycosides, lincosamides, and fluoroquinolones, have been tested for use for perioperative prophylaxis in maxillofacial surgery. However, the best regimen has not been determined. We tested the safety and the efficacy of clindamycin plus cefazolin as perioperative prophylaxis for patients undergoing major maxillofacial procedures.


METHODS
Intravenous cefazolin and clindamycin in 3 doses were administered to 155 patients undergoing major maxillofacial procedures. After surgery, patients were monitored for the presence of infection and side effects.


RESULTS
No patient experienced a fever or infection after surgery. No side effects related to these antibiotics were observed.


CONCLUSIONS
The antibiotics used as prophylaxis in maxillofacial surgery should possess an adequate coverage against gram-positive aerobic and anaerobic cocci as well as gram-negative bacilli. Prophylaxis with cefazolin plus clindamycin in major maxillofacial seems safe and effective.
Lazzarini
Luca
L
Department of Infectious Diseases and Tropical Medicine, San Bortolo Hospital, Vicenza, Italy. luca.lazzarini@ulssvicenza.it
Brunello
Massimo
M
Padula
Ernesto
E
de Lalla
Fausto
F
D000293:Adolescent; D000328:Adult; D000368:Aged; D019072:Antibiotic Prophylaxis; D002437:Cefazolin / Q000627:therapeutic use*; D002981:Clindamycin / Q000627:therapeutic use*; D004359:Drug Therapy, Combination / Q000627:therapeutic use*; D005260:Female; D005334:Fever / Q000517:prevention & control; D005500:Follow-Up Studies; D016908:Gram-Positive Bacterial Infections / Q000517:prevention & control; D006095:Gram-Positive Cocci / Q000187:drug effects; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D019647:Oral Surgical Procedures; D011446:Prospective Studies; D012449:Safety; D013530:Surgical Wound Infection / Q000517:prevention & control; D016896:Treatment Outcome
D002981:Clindamycin; D002437:Cefazolin