Complications associated with postoperative antibiotic prophylaxis after breast surgery

Am J Surg. 2009 Oct;198(4):553-6. doi: 10.1016/j.amjsurg.2009.06.003.

Abstract

Background: Evidence supports single-dose preoperative antibiotic (ABX) prophylaxis for breast surgery; however, limited data exist regarding the incidence and type of antibiotic complications postoperatively.

Methods: Breast/axillary surgeries between July 2004 and June 2006 were reviewed. Complications were analyzed by antibiotic group: preoperative prophylaxis, postoperative prophylaxis, and therapeutic intent. The Fisher exact test was used to compare complication rates.

Results: A total of 389 patients underwent breast/axillary surgeries during the study period. A total of 363 (93%) patients received ABX: 353 (91%) received a single preoperative dose, 91 (23%) received postoperative ABX prophylaxis, and 76 (201%) received ABX for therapeutic intent. Among patients receiving ABX, 15 (4%) had an ABX-related complication. The ABX-related complication rate was significantly higher among those receiving postoperative prophylaxis (5.5%; 5 of 91) compared with those receiving preoperative ABX alone (0%; 0 of 214) (P = .002).

Conclusions: Drug-related complications were uncommon with preoperative ABX prophylaxis. Considering the potential complications of ABX after breast surgery, the use of postoperative prophylaxis should be reexamined.

MeSH terms

  • Anti-Bacterial Agents / adverse effects*
  • Antibiotic Prophylaxis / adverse effects*
  • Breast Neoplasms / surgery*
  • Female
  • Humans
  • Mastectomy / adverse effects
  • Postoperative Period
  • Retrospective Studies
  • Surgical Wound Infection / etiology
  • Surgical Wound Infection / prevention & control*
  • Time Factors

Substances

  • Anti-Bacterial Agents