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Annals of Surgical Oncology

, Volume 16, Issue 9, pp 2464–2469 | Cite as

Postoperative Prophylactic Antibiotics and Surgical Site Infection Rates in Breast Surgery Patients

  • Alyssa D. Throckmorton
  • Judy C. Boughey
  • Sarah Y. Boostrom
  • Andrea C. Holifield
  • Melissa M. Stobbs
  • Tanya Hoskin
  • Larry M. Baddour
  • Amy C. Degnim
Breast Oncology

Abstract

Background

A single preoperative prophylactic dose of an intravenous antibiotic with antistaphylococcal activity is standard of care for breast and axillary surgical procedures. Some surgeons also prescribe postoperative prophylaxis for all patients with drains to prevent infection despite its lack of proven efficacy.

Methods

A retrospective chart review of patients with breast and/or axillary surgical procedures between July 2004 and June 2006 were included. Data were collected on patient demographics, procedure types, and use of prophylactic antibiotics. Surgical site infection (SSI) was defined by means of Centers for Disease Control and Prevention criteria, including patients meeting the physician diagnosis criterion if an antibiotic was prescribed for a clinical diagnosis of cellulitis. χ2 and Fisher’s exact tests were used to compare SSI rates.

Results

Three hundred fifty-three patients with 436 surgical sites who received either preoperative or both pre- and postoperative antibiotic were analyzed. Overall, the SSI rate was 7.8% (34 of 436 surgical sites). Eighty-five patients (24%) with 127 surgical sites were provided both preoperative and postoperative prophylactic antibiotics. The SSI rates did not differ statistically (P = .67) for the groups that did (95% confidence interval, 4.8–15.0; 11 of 127 surgical sites, 8.7%) and did not receive postoperative antibiotic prophylaxis (95% confidence interval, 5.0–11.0; 23 of 309, 7.4%).

Conclusions

Although the overall number of patients who developed SSI was relatively small, there was no reduction in the SSI rate among those who received postoperative antibiotic prophylaxis. Because of the potential adverse events associated with antibiotic use, further evaluation of this practice is required.

Keywords

Sentinel Lymph Node Biopsy Axillary Dissection Axillary Operation Preoperative Antibiotic Prophylaxis Postoperative Prophylaxis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgment

We thank Marilyn Churchward for her help preparing the manuscript.

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Copyright information

© Society of Surgical Oncology 2009

Authors and Affiliations

  • Alyssa D. Throckmorton
    • 1
  • Judy C. Boughey
    • 1
  • Sarah Y. Boostrom
    • 1
  • Andrea C. Holifield
    • 1
  • Melissa M. Stobbs
    • 2
  • Tanya Hoskin
    • 3
  • Larry M. Baddour
    • 4
  • Amy C. Degnim
    • 1
  1. 1.Department of SurgeryMayo ClinicRochesterUSA
  2. 2.Mayo Medical SchoolMayo ClinicRochesterUSA
  3. 3.Division of Biomedical Statistics and InformaticsMayo ClinicRochesterUSA
  4. 4.Division of Infectious DiseasesMayo ClinicRochesterUSA

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