Cephazolin and metronidazole prophylaxis in head and neck surgery

A seven-day course of cephazolin and metronidazole chemoprophylaxis for clean-contaminated head and neck oncological procedures is compared to results with previously published antibiotic regimens. Aetiological factors associated with increased rates of wound complications are analyzed. Retrospective analysis of procedures over a six-year period was performed. The overall wound complication rate was 28.1 per cent, comparing favourably with previously published results. A major fistula was the most common complication with a rate of 9.2 per cent. Factors statistically associated with increased rates of wound complications included: radical neck dissection, extended surgical procedures requiring flap reconstruction, previous tracheotomy, and race. This is the largest single institutional study to show that a seven-day course of cephazolin and metronidazole is an effective chemoprophylactic regimen in head and neck surgery.