Cefotaxime prophylaxis in major non-contaminated head and neck surgery: one-dayvs.seven-day therapy

1993 ◽  
Vol 107 (1) ◽  
pp. 30-32 ◽  
Author(s):  
Erkan Mustafa ◽  
Aslan Tahsin
Keyword(s):  
Antibiotic Prophylaxis ◽  
Wound Infection ◽  
Head And Neck ◽  
Neck Surgery ◽  
Head And Neck Surgery ◽  
Major Surgery ◽  
Double Blind Study ◽  
Antibiotic Administration ◽  
Double Blind ◽  
Perioperative Antibiotic Prophylaxis

AbstractPatients who undergo major surgery of head and neck benefit from perioperative antibiotic prophylaxis. This study was developed to determine if seven days of antibiotic administration would be more effective than one day. A prospective randomized double blind study was designed. Patients were randomly assigned to receive cefotaxime sodium for either 24 hours or seven days. In each case, the drug was administered intramuscularly, beginning one to two hours pre-operatively and continued for the prescribed period. Sixty patients were included in the trial. Of 30 patients assigned to one day of perioperative prophylaxis, wound infection developed in four (13 per cent). Of 30 patients assigned to seven days of perioperative antibiotic prophylaxis, wound infection developed in three (10 per cent) (P>0.05). These data suggest that no beneficial effect from administration of antibiotics for longer than 24 hours post-operatively can be achieved in patients who undergo major head and neck surgery.

Antibiotic Prophylaxis in High-Risk Head and Neck Surgery: One-Day vs. Five-Day Therapy

1986 ◽  
Vol 95 (5) ◽  
pp. 554-557 ◽  
Author(s):  
Jonas T. Johnson ◽  
David E. Schuller ◽  
Fred Silver ◽  
Jack L. Gluckman ◽  
Richard K. Newman ◽  
...  
Keyword(s):  
Antibiotic Prophylaxis ◽  
Wound Infection ◽  
Head And Neck ◽  
Neck Surgery ◽  
Pedicled Flap ◽  
Double Blind Study ◽  
Antibiotic Administration ◽  
Flap Reconstruction ◽  
Double Blind ◽  
Perioperative Antibiotic Prophylaxis

Patients who undergo major contaminated surgery of the head and neck benefit from perioperative antibiotic prophylaxis. This study was developed to determine if 5 days of antibiotic administration would be more effective than 1 day. A multi-institutional prospective randomized double-blind study was designed. Patients who were identified as requiring pedicled flap reconstruction were potential candidates for the study. Later, patients were randomly assigned to receive cefoperazone sodium for either 24 hours or 120 hours. In each case, the drug was administered intravenously, beginning 1 to 2 hours preoperatively and continued for the prescribed period. One hundred nine patients were evaluable. Fifty-three patients were assigned to 1 day of perioperative prophylaxis. Wound Infection developed in ten patients (18.9%). Fifty-six patients were assigned to 5 days of perioperative antibiotic prophylaxis. Wound infection developed in 14 (25%) of these patients ( P >.05). These data suggest that no beneficial effect from administration of antibiotics for longer than 24 hours postoperatively can be achieved in patients who undergo myocutaneous flap reconstruction.

Antibiotic Prophylaxis in Clean-Contaminated Head and Neck Surgery: A Systematic Review and Meta-analysis

2017 ◽  
Vol 157 (4) ◽  
pp. 580-588 ◽  
Author(s):  
Peter M. Vila ◽  
Joseph Zenga ◽  
Susan Fowler ◽  
Ryan S. Jackson
Keyword(s):  
Antibiotic Prophylaxis ◽  
Wound Infection ◽  
Head And Neck ◽  
Meta Analysis ◽  
Neck Surgery ◽  
Wound Infection Rate ◽  
Head And Neck Surgery ◽  
Medical Librarian ◽  
Clean Contaminated ◽  
Systemic Antibiotics

Objective To determine the optimal duration and type of antibiotic prophylaxis in patients undergoing clean-contaminated resection for head and neck cancer. Data Sources Search strategies were created by a medical librarian, implemented in multiple databases, and completed in June 2016. Review Methods The population of interest was adults ≥18 years undergoing clean-contaminated head and neck surgery, intervention was postoperative antibiotic prophylaxis, comparator was duration and types of antibiotics used, outcome was the wound infection rate, and the study design was randomized controlled trials (RCTs). Studies were excluded if not randomized, did not use systemic antibiotics, did not study wound infections, or included children. After excluding duplicates, the search strategy yielded 427 abstracts. After applying inclusion and exclusion criteria, 67 studies were screened, leaving 19 RCTs for review. PRISMA guidelines were followed. A random-effects model was used for meta-analysis. Results Meta-analysis of 340 patients in 4 RCTs showed that the pooled relative risk of wound infection was 0.98 (95% confidence interval [CI], 0.58-1.61; P = .718; I2 = 0.0%) in patients receiving 1 day vs 5 days of prophylaxis. Conclusion This study provides evidence that there is no difference in the risk of wound infection with 1 day vs 5 days of systemic antibiotic prophylaxis in clean-contaminated head and neck surgery, consistent with existing guidelines. Future large randomized trials are needed to more clearly define the appropriate choice of prophylaxis in penicillin-allergic patients.

Cefazolin vs Moxalactam? A Double-blind Randomized Trial of Cephalosporins in Head and Neck Surgery

1986 ◽  
Vol 112 (2) ◽  
pp. 151-153 ◽  
Author(s):  
J. T. Johnson ◽  
V. L. Yu ◽  
E. N. Myers ◽  
R. L. Wagner ◽  
B. A. Sigler
Keyword(s):  
Randomized Trial ◽  
Head And Neck ◽  
Neck Surgery ◽  
Head And Neck Surgery ◽  
Double Blind

Antibiotic prophylaxis in clean head and neck surgery: A prospective randomised controlled trial

2018 ◽  
Vol 43 (6) ◽  
pp. 1508-1512
Author(s):  
Yotam Shkedy ◽  
Sagit Stern ◽  
Yuval Nachalon ◽  
Dana Levi ◽  
Inga Menasherov ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Antibiotic Prophylaxis ◽  
Head And Neck ◽  
Controlled Trial ◽  
Neck Surgery ◽  
Head And Neck Surgery ◽  
Randomised Controlled

Wound Infection in Head and Neck Surgery: Implications for Perioperative Antibiotic Treatment

1997 ◽  
Vol 76 (11) ◽  
pp. 790-798 ◽  
Author(s):  
Randal S. Weber
Keyword(s):  
Wound Infection ◽  
Head And Neck ◽  
Antibiotic Treatment ◽  
Single Agent ◽  
Cost Effective ◽  
Neck Surgery ◽  
Head And Neck Surgery ◽  
Beta Lactamase ◽  
Beta Lactam ◽  
Clean Contaminated

Perioperative antibiotic treatment significantly reduces the risk of postoperative wound infection and is cost-effective in clean-contaminated head and neck operations. A clear consensus on the most suitable single agent or combination is, however, lacking. Most surgical wound infections involve both gram-positive and gram-negative aerobes and anaerobes; some organisms may exhibit antibiotic resistance through beta-lactamase production. Comparative trials have indicated that combinations with both aerobic and anaerobic activity provide protection superior to that achieved with single agents active against only aerobic pathogens. Recent results suggest that the beta-lactam/beta-lactamase-inhibitor combination ampi-cillin/sulbactam is cost-effective for perioperative treatment of patients undergoing head and neck surgery.

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