Prospective, randomized, double-blind study of prophylactic antibiotics in axillary lymph node dissection.

Abstract

BACKGROUND:

Antibiotic prophylaxis is controversial in patients undergoing axillary lymph node dissection (ALND). We determined whether preoperative antibiotics decreased incidence or treatment cost of infectious complications following ALND.

METHODS:

Two hundred patients entered this prospective, randomized, double-blind trial. Patients received either placebo or cefonicid preoperatively. Loco-regional signs of infection were monitored for 4 weeks postoperatively.

RESULTS:

There was a trend toward fewer infections in the prophylactic group (placebo 13% versus cefonicid 6%; P = 0.080). Cefonicid significantly decreased severe infections requiring hospitalization (placebo 8% versus cefonicid 1%; P = 0.033). Cefonicid also decreased the treatment cost of infection per patient ($49.80 versus $364.87).

CONCLUSIONS:

We demonstrated a trend toward fewer overall infections and significantly fewer severe infections in patients given prophylactic antibiotics, which translated into a decrease in the cost of treatment for infectious complications. These findings support antibiotic prophylaxis for patients undergoing ALND.

• Authors: R J Bold, P F Mansfield, D H Berger, R E Pollock, S E Singletary, F C Ames, C M Balch, D C Hohn, M I Ross
• Journal: American journal of surgery (Am J Surg) Vol. 176 Issue 3 Pg. 239-43 (Sep 1998) ISSN: 0002-9610 [Print] United States
• PMID: 9776150 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Cephalosporins
• Cefonicid

Topics

• Adult
• Aged
• Aged, 80 and over
• Antibiotic Prophylaxis (economics, methods, statistics & numerical data)
• Axilla
• Cefonicid (administration & dosage, economics)
• Cephalosporins (administration & dosage, economics)
• Cost-Benefit Analysis
• Double-Blind Method
• Female
• Humans
• Infusions, Intravenous
• Lymph Node Excision (economics, methods, statistics & numerical data)
• Male
• Middle Aged
• Prospective Studies
• Surgical Wound Infection (prevention & control)