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October 1988

Wound Prophylaxis With Metronidazole in Head and Neck Surgical Oncology

Arch Otolaryngol Head Neck Surg. 1988;114(10):1083. doi:10.1001/archotol.1988.01860220017001

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At the January 1988 meeting of the Western Section of the Triological Society, Robbins and collaborators from the University of Texas–M. D. Anderson Hospital, Houston, reported their results of a prospective randomized study of patients undergoing head and neck oncologic surgical procedures. The patients were divided in two groups: group A received cefazolin, 1000 mg intravenously (IV) one hour preoperatively and 500 mg every eight hours for a total of six doses, and metronidazole (Flagyl), 500 mg IV one hour preoperatively and 250 mg IV every eight hours postoperatively for six doses. Group B received cefazolin alone in the same dosage and regimen.

The rate of wound infection in group A (158 patients) was 9.5% compared with 18.6% in group B (172 patients) (P =.03). Patients undergoing clean procedures had a 4.9% infection rate compared with clean-contaminated and contaminated procedures, which had a higher infection rate of 3.5-fold and 6.5-fold,

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