Preoperative Antibiotics Do Not Reduce Postoperative Infections Following Needle-Localized Lumpectomy

Breast J. 2017 Jan;23(1):49-51. doi: 10.1111/tbj.12679. Epub 2016 Sep 12.

Abstract

Many surgeons routinely use a single preoperative prophylactic dose of an antibiotic prior to needle-localized lumpectomy, despite the lack of evidence that this practice reduces the rate of infection. The aim of this study is to determine if antibiotic administration reduces wound infection for needle-localized lumpectomy. A retrospective chart review of patients that underwent needle-localized lumpectomy from 2010 to 2012 was conducted. Data regarding patient demographics, comorbid conditions, medical history, operative details, and pathology were collected. Surgical infections requiring opening of the wound or treatment with antibiotics were documented if occurred during the first 3 months following surgery. Fisher's exact tests were used for statistical analyses. Two hundred and twenty patients were identified. Thirty-six percent (80/220) of patients received preoperative prophylactic antibiotics. The antibiotic and the nonantibiotic group were similar in age, body mass index, tobacco use, history of radiation, history of neo-adjuvant chemotherapy, duration of surgery, duration needle in place, and pathology. Two percent (4/220) of patients had wound infections. Two percent (3/140) of patients in the nonantibiotic group had infections, versus 1% (1/80) in the antibiotic group. In an analysis of patients that developed infections (n = 4) and patients that did not (n = 216), there was no statistically significant difference in patient demographic, duration of surgery, duration of time needle in place, or pathology. It is safe to omit the use of antibiotics prior to needle-localized lumpectomy and avoid the cost of the medication, patient adverse reactions, and increase in resistant organisms.

Keywords: antibiotics; breast surgery; cellulitis; infection.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / therapeutic use
  • Antibiotic Prophylaxis*
  • Breast Neoplasms / surgery*
  • Female
  • Humans
  • Mastectomy, Segmental / adverse effects*
  • Mastectomy, Segmental / instrumentation
  • Mastectomy, Segmental / methods*
  • Middle Aged
  • Needles
  • Postoperative Complications / prevention & control*
  • Retrospective Studies
  • Surgical Wound Infection / etiology
  • Surgical Wound Infection / prevention & control*
  • Time Factors
  • Treatment Outcome
  • Young Adult

Substances

  • Anti-Bacterial Agents