Ampicillin-sulbactam vs clindamycin in head and neck oncologic surgery. The need for gram-negative coverage

Arch Otolaryngol Head Neck Surg. 1992 Nov;118(11):1159-63. doi: 10.1001/archotol.1992.01880110027007.


This study was undertaken to assess whether gram-negative antimicrobial coverage is required in patients undergoing head and neck oncologic surgery. Ampicillin sodium-sulbactam sodium and clindamycin phosphate were compared in a prospective, randomized, parallel, double-blind trial of 212 patients undergoing head and neck procedures involving clean-contaminated wounds. Both antibiotics were given up to 1 hour before surgery and continued at 6-hour intervals after surgery for an additional eight doses. Fourteen infections occurred in the ampicillin-sulbactam-treated group (13.3%) and 29 infections in the clindamycin-treated group (27.1%). From patients receiving clindamycin, 29 gram-negative organisms were isolated, compared with six from those patients receiving ampicillin-sulbactam. This finding supports the need for gram-negative coverage in patients undergoing clean-contaminated head and neck oncologic surgery.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Ampicillin / therapeutic use*
  • Clindamycin / therapeutic use*
  • Drug Therapy, Combination / therapeutic use
  • Head and Neck Neoplasms / surgery
  • Humans
  • Sulbactam / therapeutic use*
  • Surgical Wound Infection / prevention & control*


  • Clindamycin
  • sultamicillin
  • Ampicillin
  • Sulbactam