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.

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.

scholarly journals Corrigendum

2018 ◽  
Vol 159 (2) ◽  
pp. 402-402
Keyword(s):  
Systematic Review ◽  
Antibiotic Prophylaxis ◽  
Head And Neck ◽  
Meta Analysis ◽  
Neck Surgery ◽  
Online Version ◽  
The Third ◽  
Clean Contaminated ◽  
Washington University ◽  
Head Neck

Vila PM, Zenga J, Fowler S, Jackson RS. Antibiotic prophylaxis in clean-contaminated head and neck surgery: a systematic review and meta-analysis. Otolaryngol Head Neck Surg. 2017;157:580-588. (Original DOI: 10.1177/0194599817712215) This article was printed in the October 2017 issue with the third author, Susan Fowler, omitted. The online version of this article has been corrected to accurately reflect Susan Fowler’s authorship: Susan Fowler’s name was added as the third author in the byline and her affiliation was added to the footnotes (Washington University in St Louis, St Louis, Missouri, USA). Her contributions have also been added to the Author Contributions section.

scholarly journals Comparision of Efficacy of Amoxicillin and Ciprofloxacin in Clean Contaminated Ear Surgery During Early Post Operative Period

2018 ◽  
Vol 5 (2) ◽  
pp. 8-10
Author(s):  
Kumud Chapagain ◽  
Rais Pokharel ◽  
Kumud Kumar Kafle ◽  
Bimal Kumar Sinha
Keyword(s):  
Prospective Study ◽  
Wound Infection ◽  
Head And Neck ◽  
Neck Surgery ◽  
Head And Neck Surgery ◽  
Ear Surgery ◽  
Common Procedure ◽  
Post Operative Period ◽  
Clean Contaminated

Objective: To compare the efficacy of amoxicillin and ciprofloxacin used in clean contaminated ear surgery during the early post operative period.Materials and Methods: It is a longitudinal, prospective study conducted at Department of Otorhinolaryngology and Head and Neck Surgery, TUTH from 1st April 2011 to 30th December 2011.  Patient who underwent clean contaminated ear surgery were followed up on 1st, 3rd and 7th post – operative day (POD) and wounds were inspected for any signs of wound infection.Results: 103 patients who under went various clean contaminated ear surgeries were included in this study. Maximum patients were aged 14-29 years. Ciprofloxacin was prescribed to 80 (77.7%) patients and amoxicillin to 23 (20.3%) patients. Overall wound infection was present on 6.2% (5/80) patients receiving ciprofloxacin and on 4.34% (1/23) patients receiving amoxicillin. The  most common procedure performed was MRM (53%). Wound infection was present in 9% (4/44) of patients undergoing MRM under coverage of ciprofloxacin and on 9% (1/11) patients under coverage of amoxicillin.Conclusion: Though the rate of wound infection was more in patient using ciprofloxacin than amoxicillin but it was not statically significant.Nepalese Journal of ENT Head and Neck Surgery, Vol. 5, No. 2, 2014, page: 8-10

scholarly journals Perioperative Antibiotics in Clean-Contaminated Head and Neck Surgery: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 37 (4) ◽  
pp. 1360-1380 ◽  
Author(s):  
Vincent Vander Poorten ◽  
Saartje Uyttebroek ◽  
K. Thomas Robbins ◽  
Juan P. Rodrigo ◽  
Remco de Bree ◽  
...  
Keyword(s):  
Systematic Review ◽  
Head And Neck ◽  
Meta Analysis ◽  
Neck Surgery ◽  
Head And Neck Surgery ◽  
Perioperative Antibiotics ◽  
Clean Contaminated

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.

scholarly journals Incidence of Post Operative Wound Infection Following the Use of Antibiotics in Clean Contaminated Head and Neck Surgery in a Tertiary Care Centre in Eastern Nepal

2017 ◽  
Vol 1 (1) ◽  
pp. 51-55 ◽  
Author(s):  
K. Chapagain ◽  
R. Pokharel ◽  
R. Acharya ◽  
S. Shah ◽  
B.D. Paranjape
Keyword(s):  
Wound Infection ◽  
Head And Neck ◽  
Tertiary Care ◽  
College Teaching ◽  
Neck Surgery ◽  
Head And Neck Surgery ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Clean Contaminated ◽  
Operative Wound

Introduction Post operative wound infection continues to be the major concern even after the appropriate antibiotic coverage.Objective To find out the incidence of post operative wound infection following the use of antibiotics in clean contaminated head and neck surgery in a tertiary care centre in Eastern Nepal.Methodology It is a prospective study conducted at Department of Otorhinolaryngology and Head and Neck Surgery, Nobel Medical  College Teaching Hospital, Biratnagar from 14th April 2013 to 12th April 2015. Patient who underwent clean contaminated head and neck surgery were followed up on 1st, 3rd and 6th post–operative day (POD) and wounds were inspected for any signs of wound infection.Results A total of 144 patients undergoing various clean contaminated head and neck surgeries were included in this study. Tonsillectomy was the commonest surgery performed (40.27%). An overall wound infection rate was 11.80%. Serous discharge rd from the surgical site observed on 3rd post operative day was the most common presentation of wound infection (29.41%). Parotidectomy was the surgery presenting with highest rate of wound infection (31.25%).Conclusion This study concludes that even the best technique and appropriate antibiotic has not completely eliminated the problem of wound infection in clean contaminated head and neck surgery.Birat Journal of Health Sciences 2016 1(1): 51-55

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