Current use of antibiotic prophylaxis in breast surgery: a nationwide survey

There is currently no consensus regarding the use of antibiotic prophylaxis in breast surgery. This postal survey aimed to establish the current practice in perioperative antibiotic use for breast surgery in the United Kingdom. Questionnaires were sent to 406 breast surgeons, enquiring about antibiotic use for common breast procedures. A total of 266 completed questionnaires were returned (65.5%). Over 80% of surgeons who performed breast augmentations, myocutaneous flap reconstructions and implant reconstructions used antibiotic prophylaxis. Up to 33% used antibiotic prophylaxis for wide local excisions (WLEs), mastectomies and axillary surgery for breast cancer, while 62% and 45% used antibiotics for breast reductions and duct excisions, respectively. The most common antibiotic used was co-amoxiclav. The variation in practice regarding antibiotic prophylaxis in breast surgery reflects the lack of reliable evidence for its efficacy. Further randomised controlled trials are required, taking into consideration specific risk factors affecting postoperative infection rate for breast surgery.