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

Richard J Bold, Paul F. Mansfield, David H. Berger, Raphael E. Pollock, S. Eva Singletary, Frederick C. Ames, Charles M. Balch, David C. Hohn, Merrick I. Ross

Research output: Contribution to journalArticle

33 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)239-243
Number of pages5
JournalAmerican Journal of Surgery
Volume176
Issue number3
DOIs
StatePublished - Sep 1998
Externally publishedYes

ASJC Scopus subject areas

  • Surgery

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    Bold, R. J., Mansfield, P. F., Berger, D. H., Pollock, R. E., Singletary, S. E., Ames, F. C., Balch, C. M., Hohn, D. C., & Ross, M. I. (1998). Prospective, randomized, double-blind study of prophylactic antibiotics in axillary lymph node dissection. American Journal of Surgery, 176(3), 239-243. https://doi.org/10.1016/S0002-9610(98)00154-8