8. A study of the pattern of antibiotic use in major head and neck cancer surgeries

The aim of the present study is to the rationale behind the use of antibiotic in major head and neck cancer surgeries and also the effectiveness of antibiotics in the prevention and treatment of post-operative infections. The antibiotic use was studied in patients undergoing head and neck cancer surgeries for a period of 1 years. This study was planned to evaluate the pattern of antibiotic use for major head and neck cancer surgeries, both pre-operatively as well as post-operatively and to assess the outcome. The settings and design of this study was tertiary care teaching hospital, prospective and open study. A prospective study was conducted which included 50 patients undergoing major head and neck cancer surgery admitted to the department of ENT and Head and Neck. Relevant information on each patient was collected according to the proforma designed for the study. The antibiotics used pre-operatively and post-operatively were noted down and also any change in the antibiotic administration, with reasons for the change. The percentage of patients with wound infection and response to any particular antibiotic and also the duration of hospital stay were noted. Data were analyzed statistically using mean and standard deviation. The 70% of the patients were females and 36% of them were middle aged with no predisposition factors like fungation, radiation, tracheostomy and fistula. 78% of the patients had carcinoma of the oral cavity while 2% presented with carcinoma of the paranasal sinus, nose and thyroid. The combination of cefazolin and metronidazole was effective in treating post-operative wound infection in 39% of the patients. Staphylococcus aureus, pseudomonas, anaerobes and klebsiella were the organisms isolated from the wound. In conclusion, today’s major head and neck onco-surgery with reconstructive procedures is generally safe owing to improvement in surgical skills and better antibiotic use.