FRIDAY, May 19, 2023 (HealthDay News) — For patients undergoing postmastectomy breast reconstruction (PMBR), extended antibiotic prophylaxis (EAP) does not prevent infection, admission, reoperation, or explantation rates, according to a study published in the May issue of Plastic and Reconstructive Surgery.
Mark Sisco, M.D., from NorthShore University HealthSystem in Evanston, Illinois, and colleagues conducted a retrospective study of 1,077 women who underwent immediate prosthetic PMBR from January 2008 to May 2020 to compare 90-day outcomes between EAP-positive and EAP-negative approaches. All patients received intravenous antibiotics preoperatively and up to 24 hours after surgery; before October 2016, patients also received oral antibiotics until drain removal (EAP). The EAP-positive and EAP-negative groups included 1,004 and 683 breasts, respectively.
The researchers observed no differences between the EAP-positive and EAP-negative groups in terms of surgical site infection (odds ration [OR], 0.83; 95 percent confidence interval [CI], 0.56 to 1.25; P = 0.38), admission (OR, 0.78; 95 percent CI, 0.41 to 1.48; P = 0.44), reoperation (OR, 1.01; 95 percent CI, 0.68 to 1.48; P = 0.97), or explantation rates (OR, 1.06; 95 percent CI, 0.66 to 1.71; P = 0.81). The likelihood of developing gram-negative infections was increased in the EAP-positive group. Thirteen (2.0 percent) and four (0.6 percent) EAP-positive women, respectively, developed allergic reactions and Clostridium difficile colitis attributable to the EAP.
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“We hope that our experience will give surgeons additional evidence and courage to change their practice,” the authors write.
One author disclosed financial ties to Surgical Innovation Associates.
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