Cefazolin prophylaxis in head and neck cancer surgery

Area of Science:

• Oncology
• Infectious Disease
• Surgical Prophylaxis

Background:

• Cancer surgery involving the upper aerodigestive tract carries a high risk of surgical site infections.
• Effective prophylactic strategies are crucial to minimize postoperative complications.

Purpose of the Study:

• To evaluate the efficacy of prophylactic cefazolin in reducing infection rates in patients undergoing head and neck cancer surgery.
• To assess the impact of cefazolin on both wound and non-wound infections post-surgery.

Main Methods:

• A prospective, randomized, double-blind, single-hospital study.
• Patients received either intramuscular cefazolin (1 gm pre-op, then 0.5 gm q6h x 4 doses) or a placebo.
• Infection incidence was compared between the antibiotic and placebo groups.

Main Results:

• The infection rate was significantly lower in the cefazolin group (38%) compared to the placebo group (87%) (P < 0.001).
• A total of 32 patients received cefazolin, and 23 received placebo.
• Most infections were wound-related (30), with two non-wound infections (sinusitis, pneumonia).

Conclusions:

• Perioperative cefazolin administration is effective in reducing the incidence of wound infections.
• Prophylactic cefazolin is a valuable strategy for patients undergoing cancer surgery involving entry into the oral cavity or pharynx via the neck.