Prophylactic Versus Extended Antibiotics Regimen in Breast Cancer Surgery

Abstract

Background: A single intravenous preoperative prophylactic dose of an antibiotic with antistaphylococcal activity represent standard care for breast and axillary surgical procedures. Some surgeons also prescribe postoperative extended regimen for all patients with breast and axillary surgery to prevent infection.

Objective: To evaluate the efficacy of using post-operative antibiotic (extended regimen) in breast cancer surgery to decrease surgical-siteinfections.

Patients and Methods: One hundred and five females suffering from breast cancer were enrolled in this study (from the 1stofJan. 2014 to the 30th of Dec. 2015 in Al-Yarmouk Teaching Hospital admitted by multiple surgeons).They were divided into two groups. Group [1] received single prophylactic dose of ceftriaxone injection 1gm preoperatively and group [2] received extended doses postoperatively1 gram twice daily for 4days,then antibioticchangedtooralroute(cefixime 400 mgoncedaily for 7days). Thepatients in both groups discharged home in the2^nd  post-operative day and seen again after five days,then on the days,then on the day of removalof surgicalstitches(day10) and at day30.Allpatientshadclosedsuctionsurgicaldrainswhendischargedfromhospitalandremoved inday5. Second  generation cephalosporin was not used because it is not available.

Results: During the period of this study, the incidence of wound infection was 7 (15%) in group1 and 6 (10%) in group2. The p value of the incidence of wound infection in these groups was 0.55, so it is statistically not significant.

Conclusion: No statistically significant reduction in surgical wound infection among those received postoperative extended doses of antibiotic prophylaxis (i.e.group2) compared with those who received preoperative single dose of antibiotic prophylaxis (i.e.group1).