Antibiotic Prophylaxis in Breast Cancer Surgery: is it really needed?
AftabAlam, EjazIqbal, NidaJaved, Muhammad UmairSamee, MunawarFarid, Muhammad Iqbal
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ABSTRACT
Background: Breast cancer is the leading cancer globally. Surgical resection is
being considered the primary treatment option for centuries, with intentions of
curing localized tumor or extending and improving the quality of life of
others. Surgical site infection (SSI) is one of the several risks associated
with breast cancer surgery and prophylactic antibiotics can reduce the chances
of SSI. But there was no local evidence observed in literature. So we conducted
this study. The objective of this study is to compare the frequency of surgical
site infection with prophylactic antibiotics versus placebo in females
undergoing breast cancer surgery.
Methods: This
present randomized control trial was conducted at Department of Surgery, Sahara
Medical College Narowal. Informed consent was taken from all the participating
patients. Sampling was done using non-probability purposive sampling technique.
Demographic information (name, age,
contact) was also obtained. Patients were randomized prospectively into
antibiotic group (Group A; n=95) or placebo group (Group B; n=95) groups by
using lottery method. Patients were admitted in ward one day before surgery.
Group A was given 1.2g co-amoxiclav, 30 minutes before incision preoperatively
and 2 doses postoperatively for 24 hours while the group B was given tablet of
same size and shape containing vitamins but not any antibiotic. All females
underwent surgery by a single surgical team. After surgery patients were
shifted to ward and followed up for 7 days before discharge from the hospital.
Then they were followed up in OPD on day 15th and 30th
for assessment of wound and if found any sign of infection, then surgical site
infection was labeled
Results: In our
study the mean age of the patients was 55.23±8.61 years. The SSI at day 7 was
noted in 7.37% patients, at day 15 it was found in 6.3% patients and at day 30
it was observed in 10.53% patients. SSI at day 30 was noted in 20 cases in
which all the 20 cases were from group B. Statistically significant difference
was found between the study groups and the SSI at day 30 of the patients. i. e
p-value=0.000
Conclusion: According to our study results the prophylactic antibiotics
significantly reduce the risk of SSI in breast cancer patients at follow up as
compared to placebo group patients.
Keywords: Breast
cancer, Surgical Site Infection, Prophylactic antibiotics, Placebo
ABSTRACT
Background: Breast cancer is the leading cancer globally. Surgical resection is
being considered the primary treatment option for centuries, with intentions of
curing localized tumor or extending and improving the quality of life of
others. Surgical site infection (SSI) is one of the several risks associated
with breast cancer surgery and prophylactic antibiotics can reduce the chances
of SSI. But there was no local evidence observed in literature. So we conducted
this study. The objective of this study is to compare the frequency of surgical
site infection with prophylactic antibiotics versus placebo in females
undergoing breast cancer surgery.
Methods: This
present randomized control trial was conducted at Department of Surgery, Sahara
Medical College Narowal. Informed consent was taken from all the participating
patients. Sampling was done using non-probability purposive sampling technique.
Demographic information (name, age,
contact) was also obtained. Patients were randomized prospectively into
antibiotic group (Group A; n=95) or placebo group (Group B; n=95) groups by
using lottery method. Patients were admitted in ward one day before surgery.
Group A was given 1.2g co-amoxiclav, 30 minutes before incision preoperatively
and 2 doses postoperatively for 24 hours while the group B was given tablet of
same size and shape containing vitamins but not any antibiotic. All females
underwent surgery by a single surgical team. After surgery patients were
shifted to ward and followed up for 7 days before discharge from the hospital.
Then they were followed up in OPD on day 15th and 30th
for assessment of wound and if found any sign of infection, then surgical site
infection was labeled
Results: In our
study the mean age of the patients was 55.23±8.61 years. The SSI at day 7 was
noted in 7.37% patients, at day 15 it was found in 6.3% patients and at day 30
it was observed in 10.53% patients. SSI at day 30 was noted in 20 cases in
which all the 20 cases were from group B. Statistically significant difference
was found between the study groups and the SSI at day 30 of the patients. i. e
p-value=0.000
Conclusion: According to our study results the prophylactic antibiotics
significantly reduce the risk of SSI in breast cancer patients at follow up as
compared to placebo group patients.
Keywords: Breast
cancer, Surgical Site Infection, Prophylactic antibiotics, Placebo