{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T10:42:10Z","timestamp":1788432130370,"version":"build-2803163510"},"reference-count":23,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2015,5,5]],"date-time":"2015-05-05T00:00:00Z","timestamp":1430784000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2015,7]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To assess hospital\u2010 and physician\u2010level variation in pattern of perioperative antibiotic use for laryngectomy and the relationship between pattern of antibiotic use and surgical site infection (SSI), wound dehiscence, and antibiotic\u2010induced complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective analysis of University HealthSystem Consortium data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Academic medical centers and affiliated hospitals.<\/jats:p><\/jats:sec><jats:sec><jats:title>Subjects and Methods<\/jats:title><jats:p>Elective admissions for laryngectomy from 2008 to 2011 and associated 30\u2010day readmissions were analyzed with multivariate logistic regression models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 439 unique antibiotic regimens (agents and duration) identified over the first 4\u00a0days of the 1865 admissions included in this study. Ampicillin\/sulbactam, cefazolin + metronidazole, and clindamycin were the most common agents given on the day of surgery. Clindamycin was independently associated with higher odds of SSI (odds ratio [OR] = 3.87, 95% confidence interval [CI] = 2.31\u20106.49]), wound dehiscence (OR = 3.42, 95% CI = 2.07\u20105.64), and antibiotic\u2010induced complications (OR = 3.01, 95% CI = 1.59\u20105.67) when given alone; it was also associated with higher odds of SSI (OR = 2.69, 95% CI = 1.43\u20105.05) and antibiotic\u2010induced complications (OR = 2.20, 95% CI = 1.04\u20104.64) when given with other agents. These effects were stronger in a subsample of high\u2010volume physicians and hospitals.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>There is substantial variability in perioperative antibiotic strategies for laryngectomy. Clindamycin was associated with much higher odds of short\u2010term complications as compared to other common regimens. Based on these data, clinical trials should be planned to firmly establish the most effective and cost\u2010effective antibiotic management for laryngectomy and determine potential alternatives to clindamycin for penicillin\u2010allergic patients.<\/jats:p><\/jats:sec>","DOI":"10.1177\/0194599815583641","type":"journal-article","created":{"date-parts":[[2015,5,5]],"date-time":"2015-05-05T22:21:40Z","timestamp":1430864500000},"page":"60-68","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":35,"title":["Laryngectomy Complications Are Associated with Perioperative Antibiotic Choice"],"prefix":"10.1002","volume":"153","author":[{"given":"Alexander","family":"Langerman","sequence":"first","affiliation":[{"name":"Section of Otolaryngology\u2013Head and Neck Surgery Department of Surgery University of Chicago Medicine Chicago Illinois USA"},{"name":"Operative Performance Research Institute University of Chicago Medicine Chicago Illinois USA"},{"name":"Center for Health and the Social Sciences University of Chicago Medicine Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra A.","family":"Ham","sequence":"additional","affiliation":[{"name":"Center for Health and the Social Sciences University of Chicago Medicine Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Pisano","sequence":"additional","affiliation":[{"name":"Section of Infectious Diseases Department of Medicine University of Chicago Medicine Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Pariser","sequence":"additional","affiliation":[{"name":"Operative Performance Research Institute University of Chicago Medicine Chicago Illinois USA"},{"name":"Section of Urology Department of Surgery University of Chicago Medicine Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel F.","family":"Hohmann","sequence":"additional","affiliation":[{"name":"University HealthSystem Consortium Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David O.","family":"Meltzer","sequence":"additional","affiliation":[{"name":"Center for Health and the Social Sciences University of Chicago Medicine Chicago Illinois USA"},{"name":"Hospital Medicine University of Chicago Medicine Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,5,5]]},"reference":[{"key":"e_1_2_7_2_1","unstructured":"Centers for Disease Control and Prevention.CDC\u2019s top ten: 5 health achievements in 2013 and 5 health threats in 2014.http:\/\/blogs.cdc.gov\/cdcworksforyou24\u20107\/2013\/12\/cdc\u2019s\u2010top\u2010ten\u20105\u2010health\u2010achievements\u2010in\u20102013\u2010and\u20105\u2010health\u2010threats\u2010in\u20102014. 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