Prophylactic perioperative antibiotics in contaminated head and neck surgery

Controversy remains regarding the use of prophylactic antibiotic therapy in contaminated head and neck surgery. In an attempt to clarify this issue, a prospective double-blind randomized study has been undertaken in patients who were to undergo major contaminated (skin to mucosa) oncologic surgery. The drug combination gentamicin plus clindamycin was compared with cefazolin. One day of therapy was compared with five days. Results showed a statistically significant higher rate of infection with the use of cefazolin. In addition, preliminary results indicate that the longer duration of therapy decreases infection rates.