One day vs. two days of prophylactic antibiotics in patients undergoing major head and neck surgery

Abstract

Thirty patients undergoing major head and neck surgery were prospectively randomized to receive moxalactam (30 mg/kg) before surgery and for either 3 or 6 doses total postoperatively. Wound infection criteria were carefully specified and serum drug levels were monitored. Overall infection rate was 3%; the single infection occurred in a patient randomized to the 3 dose protocol. There was no statistically significant difference in infection rates between the two groups. Drug serum levels between the groups did not differ and none of the patients developed significant drug side effects. We conclude that short course prophylaxis is equally effective as more prolonged therapy. Our wound infection rate compares favorably with previous studies and supports the use of moxalactam as a prophylactive antibiotic in major head and neck surgery.