Antibiotic prophylaxis in head and neck oncologic surgery: The role of Gram-negative coverage

David Callender

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Many studies have elucidated the risk factors associated with peri-operative infection following head and neck cancer surgery (HNS), the implications of infection for total treatment cost, and the clinical benefits of successful antimicrobial prophylaxis. The most appropriate antibiotic use is achieved by focusing on patients with clean, contaminated wounds. Thereafter, the usefulness of an antibiotic agent depends on its antimicrobial spectrum, tolerability profile, and cost. Successful antimicrobial prophylaxis requires antimicrobial activity against Gram-positive, Gram-negative, and anaerobic organisms. The β-lactam/β-lactamase inhibitor combination, sulbactam-ampicillin, has just such an antimicrobial spectrum. A double-blind, randomized clinical trial, involving patients undergoing HNS, recorded a lower post-operative infection rate among patients receiving peri-operative sulbactam-ampicillin 0.5 g/1.0 g IV q6h compared with those receiving clindamycin 600 mg IV q6h (13.3 vs. 27.1%; P=0.02). Culture of strains from infected individuals indicated a significantly lower proportion of Gram-negative organisms for sulbactam-ampicillin than for clindamycin (32 vs. 81%; P<0.05). There was a significant difference in the median duration of surgery between infected and non-infected individuals (8.5 vs. 5.9 h; P<0.0001). These data support the use of sulbactam-ampicillin to reduce the incidence of post-operative infection following HNS. Copyright (C) 1999 Elsevier Science B.V.

Original languageEnglish (US)
JournalInternational Journal of Antimicrobial Agents
Volume12
Issue numberSUPPL. 1
DOIs
StatePublished - 1999
Externally publishedYes

Fingerprint

Antibiotic Prophylaxis
Neck
Head and Neck Neoplasms
Head
Clindamycin
Infection
Anti-Bacterial Agents
Lactams
Health Care Costs
Cost-Benefit Analysis
Randomized Controlled Trials
Costs and Cost Analysis
sultamicillin
Incidence
Wounds and Injuries

Keywords

  • Antimicrobial prophylaxis
  • HNS
  • Sulbactam-ampicillin

ASJC Scopus subject areas

  • Applied Microbiology and Biotechnology
  • Microbiology
  • Parasitology
  • Virology
  • Immunology and Allergy
  • Infectious Diseases

Cite this

Antibiotic prophylaxis in head and neck oncologic surgery : The role of Gram-negative coverage. / Callender, David.

In: International Journal of Antimicrobial Agents, Vol. 12, No. SUPPL. 1, 1999.

Research output: Contribution to journalArticle

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