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Antibiotic prophylaxis in elective breast surgery: A meta-analysis of randomized placebo-controlled trials.


Marizel G. Mallari-Catungal,
Loreto J. Codamos,
Remedios F. Coronel

Related Institution

Department of Medicine - St. Luke's Medical Center

Publication Information

Publication Type
Publication Sub Type
Journal Article, Original
Philippine Journal of Surgical Specialties
Publication Date
January-March 2000


Postoperative wound infection after breast surgery may result in significant morbidity, psychological trauma and additional costs. We assessed the efficacy of perioperative antibiotic prophylaxis in elective breast surgery by doing a systematic review (meta-analysis) of three randomized placebo-controlled trials involving a total of 902 patients. The prophylactic regimen used were cefazolin and cefonicid. Types of breast surgery included mastectomies (simple or modified radical), lumpectomies or segmental or simple excisions, axillary lymph node dissections and reduction mammoplasties. Patients in the placebo group (43 out of 452) had significantly higher incidence of postoperative wound infection than in the treatment group (25 out of 450) (9.5 per cent and 5.5 per cent, respectively). The absolute risk reduction (ARR) was 4 per cent (95% CI 0.5% to 7.5%); odds ratio (OR) was 0.57 (95% CI 0.35 to 0.93); and number needed to treat (NNT) was 25 (95% CI 14 to 192 patients, p0.05). Antibiotic prophylaxis significantly reduced the risk of postoperative wound infection elective breast surgery. Further studies are needed to determine the optimum timing, dose and dosage schedule of antibiotic prophylaxis, and compare the effectiveness of different antibiotics.(Author)


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