The role of prophylactic antibiotic therapy in control of staphylococcal infections following cancer surgery

Ketcham, Alfred S.; Bloch, Jean-Gérard; Crawford, Doug; Lieberman, J E; Smith, R.

doi:10.1097/00006534-196207000-00034

Cited by 8 publications

(12 citation statements)

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“…Pre-, peri-, and postoperative surgical preparation (eg, wound care and antimicrobial prophylaxis) was performed for all patients per individual institutional guidelines. A total of 189 (15%) patients developed 214 thirty-day SSIs; the median surgical duration was 9.6 hours (interquartile range [IQR], 7.9-12.0); and the median time to SSI development was 11.5 days (IQR, [7][8][9][10][11][12][13][14][15][16][17]. The most common surgical infection sites were as follows: 150 (70%), recipient site; 43 (20%), donor site; and 21 (10%), nonrecipient or donor site.…”

Section: Resultsmentioning

confidence: 99%

“…[2][3][4] While advancements in head and neck reconstruction have continued to develop, there remain few data identifying modifiable risk factors for SSI prevention. [5][6][7][8][9][10] Antibiotic prophylaxis has reduced the incidence of SSI in patients who have undergone extensive surgical revision of the head and neck, [11][12][13][14] but current surgical infection prophylaxis guideline recommendations may fail to account for the complexity of microvascular reconstruction relative to other head and neck procedures regarding spectrum and duration. 15 Previous head and neck SSI data identify polymicrobial infections involving anaerobic mouth flora and Gram-positive bacteria, but more recent findings suggest enteric Gramnegative (GN) bacteria as concerning pathogens.…”

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confidence: 99%

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Multicenter Assessment of Antibiotic Prophylaxis Spectrum on Surgical Infections in Head and Neck Cancer Microvascular Reconstruction

Veve

Greene

Williams

et al. 2018

Otolaryngol.--head neck surg.

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Objective To characterize and identify risk factors for 30-day surgical site infections (SSIs) in patients with head and neck cancer who underwent microvascular reconstruction. Study Design Cross-sectional study with nested case-control design. Setting Nine American tertiary care centers. Subjects and Methods Hospitalized patients were included if they underwent head and neck cancer microvascular reconstruction from January 2003 to March 2016. Cases were defined as patients who developed 30-day SSI; controls were patients without SSI at 30 days. Postoperative antibiotic prophylaxis (POABP) regimens were categorized by Gram-negative (GN) spectrum: no GN coverage, enteric GN coverage, and enteric with antipseudomonal GN coverage. All POABP regimens retained activity against anaerobes and Gram-positive bacteria. Thirty-day prevalence of and risk factors for SSI were evaluated. Results A total of 1307 patients were included. Thirty-day SSI occurred in 189 (15%) patients; median time to SSI was 11.5 days (interquartile range, 7-17). Organisms were isolated in 59% of SSI; methicillin-resistant Staphylococcus aureus (6%) and Pseudomonas aeruginosa (9%) were uncommon. A total of 1003 (77%) patients had POABP data: no GN (17%), enteric GN (52%), and antipseudomonal GN (31%). Variables independently associated with 30-day SSI were as follows: female sex (adjusted odds ratio [aOR], 1.6; 95% CI, 1.1-2.2), no GN POABP (aOR, 2.2; 95% CI, 1.5-3.3), and surgical duration ≥11.8 hours (aOR, 1.9; 95% CI, 1.3-2.7). Longer POABP durations (≥6 days) or antipseudomonal POABP had no association with SSI. Conclusions POABP without GN coverage was significantly associated with SSI and should be avoided. Antipseudomonal POABP or longer prophylaxis durations (≥6 days) were not protective against SSI. Antimicrobial stewardship interventions should be made to limit unnecessary antibiotic exposures, prevent the emergence of resistant organisms, and improve patient outcomes.

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Section: Resultsmentioning

confidence: 99%

mentioning

confidence: 99%

Multicenter Assessment of Antibiotic Prophylaxis Spectrum on Surgical Infections in Head and Neck Cancer Microvascular Reconstruction

Veve

Greene

Williams

et al. 2018

Otolaryngol.--head neck surg.

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“…Of the infections that occurred in this group, 3 were minor and the clinical management was not compromised. Various antibiotics, administered orally, parentally or topically, have been used with beneficial effects (Ketcham et al 1962, Echelman et al 1971, Dor & Klastersky 1976, Robinson 1976, Seagle et al 1978, Becker & Parell 1979, Becker 1981, Innes et al 1980, Mombelli et al 1981, Suarez Nieto et al 1981. Becker & Parell (1979) observed a significant reduction in postoperative sepsis, from 87% to 38%, with cefazolin.…”

Section: Discussionmentioning

confidence: 99%

“…1Although reports have been written opposing the use of prophylactic antibiotics (King 1961, Strong 1963, Ketcham et al 1962 there have been few trials advocating their benefits in major head and neck surgery (Ketcham et al 1962, Echelman et al 1971, Dor & Klastersky 1973, 1976, Robinson 1976, Seagle et al 1978, Becker & Parell 1979, Becker 1981. Unfortunately, not all have been critical.…”

Section: Introductionmentioning

confidence: 99%

Chemoprophylaxis in Major Head and Neck Surgery

et al. 1984

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“…A prospective study using penicillin and streptomycin also failed to show significant benefit (Sanchez Ubeda et al, 1958). However, several subsequent prospective studies showed a considerable decrease in infection (Ketcham et al, 1962;Nash & Hugh, 1967;Collins, Darke & Knowelden, 1968). These differences of opinion may be explained by the particular antibiotics employed.…”

Section: Discussionmentioning

confidence: 99%

Combined carbenicillin and gentamicin for prophylaxis of post-operative infection following major abdominal surgery

Bloom

1969

Postgraduate Medical Journal

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SummaryBacteriological studies with carbenicillin and gentamicin individually and with the combination of these antibiotics suggest their effect to be additive in action and often synergistic. Of sixty-five organisms tested in vitro, the majority Gram-negative, forty-seven were resistant to ampicillin, thirtyseven to carbenicillin, twenty-four to gentamicin and only six to carbenicillin plus gentamicin.Out of sixty-seven patients undergoing major abdominal surgery, thirty were randomly allocated to receive carbenicillin plus gentamicin postoperatively and of these one developed an infection.The other thirty-seven patients received either ampicillin or no antibiotic and nine developed infections.The combined antibiotic regime seems suitable for prophylaxis for patients undergoing major abdominal surgery with a high risk of infection. IntroductionThe incidence of post-operative infection following abdominal surgery constitutes a serious hazard. In one large series infection, in all sites, occurred in over 30°/o of patients undergoing large bowel and

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The role of prophylactic antibiotic therapy in control of staphylococcal infections following cancer surgery

Cited by 8 publications

References 0 publications

Multicenter Assessment of Antibiotic Prophylaxis Spectrum on Surgical Infections in Head and Neck Cancer Microvascular Reconstruction

Multicenter Assessment of Antibiotic Prophylaxis Spectrum on Surgical Infections in Head and Neck Cancer Microvascular Reconstruction

Chemoprophylaxis in Major Head and Neck Surgery

Combined carbenicillin and gentamicin for prophylaxis of post-operative infection following major abdominal surgery

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