Antibiotic prophylaxis in clean neck dissections

Abstract

This study was designed to evaluate the effects of a prophylactic antibiotic regimen on the incidence of wound infection after clean neck dissections. A prospective series of 57 patients undergoing clean neck dissections with the use of perioperative ampicillin-sulbactam for 24 hours was compared with an historical control group of 51 patients undergoing clean neck dissections with no perioperative antibiotic use. The outcome variable was the incidence of post-operative wound infection. The two groups were similar for factors reported to influence the rate of post-operative wound infection. Wound infection occurred in one patient (1.7 per cent) in the study group and in seven patients (13.3 per cent) in the control group, the difference was statistically significant (p = 0.02). These data suggest that the use of a perioperative antibiotic for 24 hours in patients undergoing clean neck dissection results in significant reduction in the incidence of post-operative wound infection.

Rational antibiotic therapy and the position of ampicillin/sulbactam

“…AMS have been confirmed by numerous studies (mainly comparative) carried out in more recent years [30,[106][107][108][109][110][111][112][113][114][115][116][117] (Table 8). Thus, there is good evidence for AMS (typically given in one or more doses of 1-2 g ampicillin/0.5-1 g sulbactam i.v.…”

Current trends in antibiotic prophylaxis for laryngectomy in the UK – a national survey

“…13 A combination of agents has proven to be more effective than a single-agent regimen. 14 Jeannon et al detected MRSA in 80 per cent of patients who developed pharyngocutaneous fistula after total laryngectomy, none of which were carriers of MRSA pre-operatively. 6 This finding indicates that MRSA is an important risk factor in fistula formation.…”

Guidelines for implementation of clinical studies on surgical antimicrobial prophylaxis (2007)

“…Cefazolin provides adequate coverage for many clean and clean-contaminated operations, 6 but AMP for operations on the distal intestinal tract mandates the use of an agent such as cefmetazole or fl omoxef, which provides anaerobic coverage. 9 In operations on the head and neck, ampicillin is recommended, but cefazolin, sulbactam/ampicillin, 24 and cefmetazole can also be used. Piperacillin is recommended for operations on the biliary tract.…”