To the Editor.—I would like to congratulate Johnson et al1 on their excellent update on the value of the newer antibiotics as prophylaxis in major head and neck surgery. At the same time, I think that if they had read the publication by Becker and myself2 a little closer, they would not have proceeded with the placebo portion of their study and could have thereby prevented most of the infections in these patients.
Almost six years ago we demonstrated in a double-blind, prospective study that prophylactic cefazolin sodium dramatically decreased incidence of wound infection in patients undergoing contaminated head and neck cancer surgery (from 87% to 38% ). Even then we were criticized for using a placebo group. There certainly is no place for a no-treatment control group as the Institutional Review Board for Human Rights of the Eye and Ear Hospital in Pittsburgh informed Johnson et al after
PARELL GJ. Cefazolin Sodium in Prophylaxis. Arch Otolaryngol. 1984;110(9):628. doi:10.1001/archotol.1984.00800350070019
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