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Prospective, randomized, double-blind study of prophylactic antibiotics in axillary lymph node dissection
R J Bold1, P F Mansfield, D H Berger
1Department of Surgical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston 77030, USA.
American Journal of Surgery
|October 17, 1998
Summary
Preoperative antibiotics show a trend toward reducing overall infections and significantly decrease severe infections after axillary lymph node dissection (ALND). This prophylaxis also lowers treatment costs for infectious complications.
Area of Science:
- Oncology
- Infectious Diseases
- Surgical Innovation
Background:
- Antibiotic prophylaxis use in axillary lymph node dissection (ALND) remains debated.
- Investigating the impact of preoperative antibiotics on infectious complications post-ALND.
Purpose of the Study:
- To determine if preoperative antibiotic administration reduces the incidence and cost of infectious complications following ALND.
- Evaluating the efficacy of cefonicid as a prophylactic agent.
Main Methods:
- A prospective, randomized, double-blind trial involving 200 patients undergoing ALND.
- Patients received either cefonicid or a placebo preoperatively.
- Postoperative monitoring for loco-regional infection signs for 4 weeks.
Main Results:
- A trend towards fewer overall infections was observed in the cefonicid group (6%) compared to placebo (13%).
- Cefonicid significantly reduced severe infections requiring hospitalization (1% vs. 8%).
- The treatment cost for infectious complications per patient was substantially lower with cefonicid ($49.80 vs. $364.87).
Conclusions:
- Prophylactic antibiotics, specifically cefonicid, demonstrate a trend in reducing overall infections post-ALND.
- Significant reduction in severe, hospital-requiring infections and associated treatment costs supports antibiotic prophylaxis.
- Findings advocate for the routine use of antibiotic prophylaxis in patients undergoing ALND.