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April 1984

Efficacy of Two Third-Generation Cephalosporins in Prophylaxis for Head and Neck Surgery

Author Affiliations

From the Departments of Otolaryngology (Drs Johnson and Myers and Ms Thearle) and Pathology (Dr Diven) and the Division of Infectious Disease, Department of Medicine (Drs Yu and Muder), University of Pittsburgh School of Medicine; the Eye and Ear Hospital of Pittsburgh (Drs Johnson and Myers and Ms Thearle); the Veterans Administration Medical Center, Pittsburgh (Drs Yu and Muder); and the Presbyterian-University Hospital, Pittsburgh (Dr Diven).

Arch Otolaryngol. 1984;110(4):224-227. doi:10.1001/archotol.1984.00800300016003

• Optimal antimicrobial prophylaxis during head and neck surgery is as yet unclear. The semisynthetic third-generation cephalosporin antibiotics would appear to have potential usefulness because of their broad antibacterial spectrum, favorable pharmacokinetic properties, and record of safety. Eighty patients were prospectively randomized into this placebo-controlled, double-blind study to receive either placebo, cefoperazone sodium, or cefotaxime sodium preoperatively and for 24 hours postoperatively. Infection rates were 78% for the placebo group and 10% for the group receiving the cephalosporin antibiotics. Infections were polymicrobial. Anaerobic bacteria constituted 42% of the pathogens isolated. Wound and serum antibiotic concentrations exceeded the minimal inhibitory concentration of the bacterial flora. This study establishes the necessity of antimicrobial prophylaxis for contaminated oncologic procedures of the head and neck. Our experience indicates that cefoperazone and cefotaxime are particularly useful.

(Arch Otolaryngol 1984;110:224-227)

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