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 beta-lactam/beta-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 i.v. q6h compared with those receiving clindamycin 600 mg i.v. 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.
journal_name
Int J Antimicrob Agentsjournal_title
International journal of antimicrobial agentsauthors
Callender DLdoi
10.1016/s0924-8579(99)00088-6subject
Has Abstractpub_date
1999-08-01 00:00:00pages
S21-5; discussion S26-7eissn
0924-8579issn
1872-7913journal_volume
12 Suppl 1pub_type
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