amoxicillin-potassium-clavulanate-combination and Carcinoma--Squamous-Cell

Rothia mucilaginosa is a Gram-positive, coagulase-negative, encapsulated, non-spore-forming coccus considered part of the commensal flora of the oral cavity and the upper respiratory tract in humans. Its involvement has been reported in an increasing spectrum of infections, above all among immunocompromised patients. To date, only 11 cases of pneumonia due to Rothia mucilaginosa have been described in the literature. The authors report a case of pneumonia due to Rothia mucilaginosa in a 72-year-old man with laryngeal cancer and review the published cases of pneumonia due to this pathogen.

Topics: Actinomycetales Infections; Aged; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Carcinoma, Squamous Cell; Drug Resistance, Microbial; Humans; Incidental Findings; Laryngeal Neoplasms; Male; Micrococcaceae; Opportunistic Infections; Pneumonia, Bacterial; Preoperative Care; Pulmonary Disease, Chronic Obstructive; Tomography, X-Ray Computed

Perioperative antibiotic prophylaxis has significantly reduced wound infection rates in clean-contaminated head and neck surgical procedures but controversy still remains regarding the optimal antibiotic regime.. To examine the efficacy of different antibiotics in head and neck oncological surgery prophylaxis.. In this prospective, double-blind clinical trial, 189 patients with carcinoma of the upper aerodigestive tract were randomized to receive amoxicillin-clavulanate or cefazolin intravenously up to 1h before surgery and at 8-h intervals for an additional three doses.. An overall wound infection rate of 22% was observed. The infection rate in patients receiving cefazolin was 24% (22/92) vs. 21% (20/97) in those receiving amoxicillin-clavulanate; the difference was not statistically significant. Postoperative overall non-wound infection developed in 12% (22/189) patients; the rate of infection was 9.8% (9/92) in patients receiving cefazolin vs. 13.4% (13/97) in those receiving amoxicillin-clavulanate, without a statistically significant difference between the two groups. Gram-negative bacteria were more often isolated with Pseudomonas aeruginosa as the dominant species. The risk of postoperative infection was more influenced by the type of surgical procedure than by disease stage.. In clean-contaminated head and neck oncologic surgery amoxicillin-clavulanate prophylaxis was at least as efficient as cefazolin. However, when taking into account the fact that beta-lactamase containing strains have recently been spreading, amoxicillin-clavulanate should be the logical first choice.

Topics: Amoxicillin-Potassium Clavulanate Combination; Antibiotic Prophylaxis; Bronchitis; Carcinoma, Squamous Cell; Cefazolin; Double-Blind Method; Head and Neck Neoplasms; Humans; Injections, Intravenous; Laryngeal Neoplasms; Mouth Neoplasms; Pharyngeal Neoplasms; Pneumonia, Bacterial; Postoperative Complications; Prospective Studies; Pseudomonas aeruginosa; Pseudomonas Infections; Staphylococcal Infections; Streptococcal Infections; Surgical Wound Infection; Tracheitis

Topics: Adolescent; Adult; Amoxicillin-Potassium Clavulanate Combination; Androstanols; Anemia; Anesthesia; Anesthetics, Inhalation; Antibiotic Prophylaxis; Blood Transfusion; Carcinoma, Basal Cell; Carcinoma, Squamous Cell; Child; Child, Preschool; Dermatologic Surgical Procedures; Female; Humans; Laryngeal Masks; Male; Methyl Ethers; Monitoring, Intraoperative; Neuromuscular Nondepolarizing Agents; Postoperative Complications; Prospective Studies; Rocuronium; Sevoflurane; Skin Neoplasms; Xeroderma Pigmentosum; Young Adult

Topics: Aged, 80 and over; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Brain Abscess; C-Reactive Protein; Carcinoma, Squamous Cell; Debridement; Drainage; Humans; Male; Negative-Pressure Wound Therapy; Scalp; Silicones; Skin Neoplasms; Surgical Wound Dehiscence

We report the case of a 52-year-old man, ASA 3-4, malnourished, heavy smoker and drinker at the stage of chronic obstructive pulmonary disease and cirrhosis. The postoperative course of a cervical cancer surgery was complicated by a pneumonia with fatal outcome in the intensive care unit. Taking into account the patient's history and surgical requirements, this nosocomial infection did not appear easily preventable. The multiple risk factors and the few preventive measures usable were analyzed. In this context, the media and legal trend to make the doctors responsible for the nosocomial infections should be revised.

Topics: Alcoholism; Amoxicillin-Potassium Clavulanate Combination; Antibiotic Prophylaxis; Carcinoma, Squamous Cell; Ciprofloxacin; Cross Infection; Disease Susceptibility; Fatal Outcome; Humans; Iatrogenic Disease; Immunocompromised Host; Liver Cirrhosis, Alcoholic; Male; Malnutrition; Malpractice; Middle Aged; Mouth; Neck Dissection; Neoplasm Recurrence, Local; Oxygen; Penicillanic Acid; Piperacillin; Piperacillin, Tazobactam Drug Combination; Pneumonia; Postoperative Complications; Pulmonary Disease, Chronic Obstructive; Risk Factors; Smoking; Tongue Neoplasms