Document Detail


Efficacy of topical amoxicillin plus clavulanate/ticarcillin plus clavulanate and clindamycin in contaminated head and neck surgery: effect of antibiotic spectra and duration of therapy.
MedLine Citation:
PMID:  8077738     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
This prospective, randomized trial was designed to determine the efficacy and mechanism of action of topical mouthwash versus parenterally administered perioperative prophylactic antibiotics in contaminated head and neck surgery. Patients were randomly assigned to 1 of 4 treatment groups: 1 day of parenteral clindamycin (standard prophylaxis), 1 day of topical clindamycin, 5 days of topical clindamycin, or 1 day of topical amoxicillin plus clavulanate/ticarcillin plus clavulanate. Patients who received the latter regimen had fewer bacteria postoperatively compared with the other 3 treatment groups. The number of gram-negative aerobic bacilli on postoperative oral cavity cultures was increased in all 3 clindamycin groups but not in the amoxicillin plus clavulanate/ticarcillin plus clavulanate group. Parenteral clindamycin appears to exert its effect by being in the neck tissues at the time of surgery; however, all 3 topical regimens were more effective at reducing the number of bacteria in the neck viscera. Topical antibiotic prophylaxis was simple, safe, effective, and well tolerated.
Authors:
J R Grandis; R M Vickers; J D Rihs; V L Yu; J T Johnson
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Journal of infectious diseases     Volume:  170     ISSN:  0022-1899     ISO Abbreviation:  J. Infect. Dis.     Publication Date:  1994 Sep 
Date Detail:
Created Date:  1994-10-06     Completed Date:  1994-10-06     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0413675     Medline TA:  J Infect Dis     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  729-32     Citation Subset:  AIM; IM    
Affiliation:
Department of Otolaryngology, University of Pittsburgh School of Medicine, Pennsylvania.
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MeSH Terms
Descriptor/Qualifier:
Amoxicillin / administration & dosage,  therapeutic use*
Anti-Bacterial Agents / therapeutic use
Carcinoma, Squamous Cell / surgery*
Clavulanic Acid
Clavulanic Acids / administration & dosage,  therapeutic use*
Drug Administration Schedule
Drug Therapy, Combination / therapeutic use*
Gram-Negative Aerobic Bacteria / isolation & purification
Head and Neck Neoplasms / surgery*
Humans
Laryngeal Neoplasms / surgery*
Mouthwashes
Prospective Studies
Surgical Wound Infection / prevention & control*
Ticarcillin / administration & dosage,  therapeutic use*
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents; 0/Clavulanic Acids; 0/Mouthwashes; 26787-78-0/Amoxicillin; 34787-01-4/Ticarcillin; 58001-44-8/Clavulanic Acid

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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