Background: Although appropriate perioperative contaminated head and neck surgery has been antibiotic prophylaxis has significantly reduced wound infection well documented in several randomized, prospecrates in clean-contaminated head and neck surgical procedures, controversy still remains regarding the optimal antibiotic regimen.tive, double-blind clinical trials.1-6 However, con-

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 ½ hour before surgery and at 8‐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. © 1997 John Wiley & Sons, Inc. Head Neck 19: 188–193, 1997.

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Head-shaking nystagmus of peripheral vestibular origin is a response both qualitatively and quantitatively associated with the degree of the vestibular loss.