CLINDAMYCIN CEFONICID IN HEAD AND NECK ONCOLOGIC SURGERY - ONE-DAY PROPHYLAXIS IS AS EFFECTIVE AS A 3-DAY SCHEDULE

The aim of our study was to evaluate the optimal duration of antibioti c prophylaxis in major oncologic surgery of the head and neck using a novel broad spectrum drug combination: clindamycin and cefonicid. A pr ospective randomized study was carried out on 126 evaluable patients u ndergoing clean-contaminated (skin to mucosa) surgery for cancer of la rynx, pharynx or oral cavity. Cases at high surgical risk (because of need of pedicled or microvascular free flaps reconstruction), were exc luded from the study. Within 20 days after surgery, only one case of w ound infection was recorded among the 62 patients treated with the one -day schedule, versus three cases registered among the 64 subjects rec eiving three-day chemoprophylaxis. Episodes of systemic infections and eventual wound complications occurring in the first 20 days after sur gery have also been recorded. The role of potential risk factors for p ostoperative complications has been evaluated. According to our findin gs, a three-day antibiotic regimen is not more effective than a short- term (one-day) schedule in preventing wound or systemic infection in c lean-contaminated head and neck cancer surgery without flap reconstruc tion.