Bacteriological assessment of patients undergoing major head and neck surgery

The use of chemoprophylaxis in major Head and Neck surgery is controversial. Prior to conducting a prospective trial a controlled microbiological monitoring of 32 patients was performed to determine a suitable antibiotic for prophylaxis. Wound infection occurred in 22 (68%) patients with fistulae occurring in 10 of these patients (45.5%). Pre-operative cultures were of limited value in predicting subsequent sepsis. Gram-negative aerobic bacilli were the commonest group of pathogens (34.4%) isolated post-operatively. From projected resistance profiles of pathogenic and opportunistic bacteria amoxycillin and clavulanic acid (Augmentin, Beecham Pharmaceuticals) was chosen as a suitable antibiotic.