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

32 Citations (Scopus)

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

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Cefonicid
Lymph Node Excision
Double-Blind Method
Anti-Bacterial Agents
Infection
Health Care Costs
Antibiotic Prophylaxis
Placebos
Hospitalization
Incidence

ASJC Scopus subject areas

  • Surgery

Cite this

Bold, R. J., Mansfield, P. F., Berger, D. H., Pollock, R. E., Singletary, S. E., Ames, F. 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

Prospective, randomized, double-blind study of prophylactic antibiotics in axillary lymph node dissection. / Bold, Richard J; Mansfield, Paul F.; Berger, David H.; Pollock, Raphael E.; Singletary, S. Eva; Ames, Frederick C.; Balch, Charles M.; Hohn, David C.; Ross, Merrick I.

In: American Journal of Surgery, Vol. 176, No. 3, 09.1998, p. 239-243.

Research output: Contribution to journalArticle

Bold, RJ, Mansfield, PF, Berger, DH, Pollock, RE, Singletary, SE, Ames, FC, Balch, CM, Hohn, DC & Ross, MI 1998, 'Prospective, randomized, double-blind study of prophylactic antibiotics in axillary lymph node dissection', American Journal of Surgery, vol. 176, no. 3, pp. 239-243. https://doi.org/10.1016/S0002-9610(98)00154-8
Bold, Richard J ; Mansfield, Paul F. ; Berger, David H. ; Pollock, Raphael E. ; Singletary, S. Eva ; Ames, Frederick C. ; Balch, Charles M. ; Hohn, David C. ; Ross, Merrick I. / Prospective, randomized, double-blind study of prophylactic antibiotics in axillary lymph node dissection. In: American Journal of Surgery. 1998 ; Vol. 176, No. 3. pp. 239-243.
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AB - 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.

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