Paper was presented at The Western Section of the Triological Society in Rancho Mirage, California on February 2, 2008.
Antibiotics in head and neck surgery in the setting of malnutrition, tracheotomy, and diabetes†
Version of Record online: 23 FEB 2009
Copyright © 2009 The American Laryngological, Rhinological, and Otological Society, Inc.
Volume 119, Issue 3, pages 549–553, March 2009
How to Cite
Sepehr, A., Santos, B.-J. G., Chou, C., Karimi, K., Devcic, Z., Oels, S. and Armstrong, W. B. (2009), Antibiotics in head and neck surgery in the setting of malnutrition, tracheotomy, and diabetes. The Laryngoscope, 119: 549–553. doi: 10.1002/lary.20078
- Issue online: 23 FEB 2009
- Version of Record online: 23 FEB 2009
- Manuscript Received: 24 JUL 2008
- Manuscript Accepted: 25 JAN 2008
- Clean-contaminated head and neck cancer surgery;
- postsurgical wound infection;
- antibiotic prophylaxis;
The objectives of this study are to compare short vs. long antibiotic prophylaxis in the setting of malnutrition, diabetes, and tracheotomy.
Retrospective chart review.
The charts of 407 patients undergoing clean-contaminated head and neck surgery were reviewed for disease type, operation performed, length of antibiotic prophylaxis, wound complications, and length of hospital stay. Three intrinsic patient risk factors for infection (malnutrition, diabetes mellitus, and tracheotomy) were evaluated for an effect on the optimal length of antibiotic prophylaxis. The data was statistically analyzed using the two-tailed Fisher's exact test.
Overall, the incidence of infection was 7% in short-course antibiotics and 13% in long-course antibiotics (P = .06). The incidence of infection was 18% in malnourished patients and 3% in well-nourished patients (P < .0001). In malnourished patients, the incidence of infection was 16% in short-course antibiotics and 19% in long-course antibiotics (P = 1). The incidence of infection was 11% in diabetics and 23% in nondiabetics (P = .13). In diabetic patients, the incidence of infection was 0% on short-course antibiotics and 16% on long-course antibiotics (P = .55). The incidence of pneumonia was 14% in patients with tracheotomy and 5% in patients without tracheotomy (P = .0014). In patients with tracheotomy, the incidence of pneumonia was 8% on short-course antibiotics and 15% on long-course antibiotics (P = .6931).
Malnutrition and tracheotomy were associated with a higher infection rate while diabetes was not found to be a risk factor. Prolonged antibiotics were not associated with a lower infection rate in the overall group or in any subgroup. Laryngoscope, 119:549–553, 2009