Weber R S, Raad I, Frankenthaler R, Hankins P, Byers R M, Guillamondegui O, Wolf P, Smith T, Goepfert H
Department of Head and Neck Surgery, University of Texas M.D. Anderson Cancer Center, Houston 77030.
Arch Otolaryngol Head Neck Surg. 1992 Nov;118(11):1159-63. doi: 10.1001/archotol.1992.01880110027007.
This study was undertaken to assess whether gram-negative antimicrobial coverage is required in patients undergoing head and neck oncologic surgery. Ampicillin sodium-sulbactam sodium and clindamycin phosphate were compared in a prospective, randomized, parallel, double-blind trial of 212 patients undergoing head and neck procedures involving clean-contaminated wounds. Both antibiotics were given up to 1 hour before surgery and continued at 6-hour intervals after surgery for an additional eight doses. Fourteen infections occurred in the ampicillin-sulbactam-treated group (13.3%) and 29 infections in the clindamycin-treated group (27.1%). From patients receiving clindamycin, 29 gram-negative organisms were isolated, compared with six from those patients receiving ampicillin-sulbactam. This finding supports the need for gram-negative coverage in patients undergoing clean-contaminated head and neck oncologic surgery.
本研究旨在评估接受头颈肿瘤手术的患者是否需要革兰氏阴性菌抗菌覆盖。在一项前瞻性、随机、平行、双盲试验中，对212例接受涉及清洁-污染伤口的头颈手术的患者比较了氨苄西林钠舒巴坦钠和磷酸克林霉素。两种抗生素均在手术前1小时内给药，并在术后每隔6小时继续给药，共额外给药8剂。氨苄西林舒巴坦治疗组发生14例感染（13.3%），克林霉素治疗组发生29例感染（27.1%）。接受克林霉素治疗的患者分离出29株革兰氏阴性菌，而接受氨苄西林舒巴坦治疗的患者分离出6株。这一发现支持了接受清洁-污染头颈肿瘤手术的患者需要革兰氏阴性菌覆盖的观点。
