Randomized clinical trial of single-dose antibiotic prophylaxis for non-reconstructive breast surgery

Abstract

The administration of a single dose of flucloxacillin failed to reduce the rate of wound infection after non-reconstructive breast surgery.

Does Preoperative Core Needle Biopsy Increase Surgical Site Infections in Breast Cancer Surgery? Randomized Study of Antibiotic Prophylaxis

“…Therefore, we selected dicloxacillin, to which gram-positive cocci generally are sensitive. Previous studies have used azithromycin, clarithromycin, augmentin, cephalosporins, or flucloxacillin as prophylactic antimicrobial agents [2,4]. Although recent Cochrane studies and meta-analyses indicated that prophylactic antibiotics reduce the risk of SSI in patients undergoing surgery for breast cancer [1,2], our singlecenter study could not find any clear benefit for a prophylactic antibiotic associated with preoperative core biopsy.…”

“…This is reasonable because many earlier studies showed a 30-70% decrease of SSI after prophylactic antibiotics in breast cancer surgery [1,2,10]. For example, the recent negative randomized study used an expected decrease in the rate of incisional sepsis from 20% to 10% (50% decrease) [4]. If the study power goal had been a 30% difference or less to avoid a type two error, about 1,200 patients would have been needed in each group.…”

“…T he incidence of surgical site infections (SSI) in breast surgery for cancer ranges from 1-30% [1][2][3][4]. There seems to be a higher rate of infection than might be expected after other types of ''clean surgery.''…”

Dressing Wear Time after Reduction Mammaplasty

“…11,28 Further, many studies have addressed the role of antibiotics use in reduction mammaplasty. [15][16][17]19,21,29 The search for an ideal postsurgical breast dressing has led to the development of a number of different materials and application techniques. 30,31 The evidence supporting dressing standards for incisional wounds, including breast surgery wounds, is empiric and scarce, however.…”

Ongoing Consideration of Cavity Evaluation Devices in the Treatment of Breast Cancer

“…Furthermore, since there is a finite risk (1-4%) of surgical-site infection after breast-conserving surgery, to what degree does the higher incidence of infection after the open-cavity technique reflect the combined result of postlumpectomy infection and catheter-related infection. 3,4 Interestingly, the MammoSite Registry reported a higher overall incidence of acute skin toxicity compared to breast infection (12 versus 9%) and a lower incidence of acute skin toxicity with antibiotic usage (P \ 0.0001). 3 This suggests that postprocedural oral antibiotics should be routinely given to patients undergoing catheter-based APBI regardless of the timing of catheter placement.…”