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  • Title: Comparison of three prophylactic antibiotic regimens in clean-contaminated head and neck surgery.
    Author: Rodrigo JP, Alvarez JC, Gómez JR, Suárez C, Fernández JA, Martínez JA.
    Journal: Head Neck; 1997 May; 19(3):188-93. PubMed ID: 9142517.
    Abstract:
    BACKGROUND: Although appropriate perioperative antibiotic prophylaxis has significantly reduced wound infection rates in clean-contaminated head and neck surgical procedures, controversy still remains regarding the optimal antibiotic regimen. METHODS: In this prospective, double-blind clinical trial, 159 patients were randomized to receive amoxicillin-clavulanate, clindamycin plus gentamicin, or cefazolin intravenously up to 1/2 hour before surgery and at 6-hour intervals for an additional three doses. RESULTS: An overall wound infection rate of 23% was observed. Thirteen (22.8%) infections occurred in the amoxicillin-clavulanate-treated group, 11 (21.2%) in the clindamycin plus gentamicin-treated group, and 13 (26%) in the cefazolin-treated group, which was not statistically significant. Only prior medical illnesses, such as chronic obstructive pulmonary disease and diabetes mellitus, correlated with an increased wound infection rate (p = 0.018). CONCLUSIONS: Amoxicillin-clavulanate, clindamycin plus gentamicin, and cefazolin seem to have similar efficacy when administered prophylactically in clean-contaminated head and neck surgical procedures.
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