par Piccart-Gebhart, Martine ;Dor, Pierre ;Klastersky, Jean
Référence Scandinavian journal of infectious diseases, 15, SUPPL. 39, page (92-96)
Publication Publié, 1983
Article révisé par les pairs
Résumé : 429 patients undergoing surgery for head and neck tumors were involved in 4 consecutive, randomized clinical trials for antimicrobial prophylaxis: placebo versus ampicillin plus cloxacillin (2 g of each daily for 6 days), ticarcillin (5 g x 12, 8-hourly) versus carbenicillin (10 g x 12, 8-hourly) short carbenicillin prophylaxis (1 day) versus prolonged carbenicillin prophylaxis (4 days) and clindamycin (900 mg, 4 daily doses) versus clindamycin plus netilmicin (90 mg, 4 daily doses). Aerobic gram-negative strains were the microorganisms most frequently isolated either from colonized or infected wounds. The first controlled study showed a significant decrease in the rate of postoperative bacterial infections in the treated group as compared to the placebo-treated group (p < 0.05). In all the subsequent treatment groups, postoperative infection rates ranged from 6 to 16%. Short prophylaxis was as effective as prolonged prophylaxis. A regimen directed mainly against anaerobes (clindamycin) did not seem of less value than broad spectrum regimens covering most aerobic gram-negative bacilli.