Multidose antibiotic prophylaxis no better for breast implant surgery

Multiple-dose antibiotic prophylaxis is not superior to a single-dose regimen in preventing surgical site infection (SSI) after implant-based breast reconstruction, according to a study published online Sept. 16 in JAMA Network Open.

Jessica Gahm, M.D., Ph.D., from Karolinska University Hospital in Stockholm, and colleagues conducted a randomized clinical trial to assess whether multiple-dose antibiotic prophylaxis (353 patients) is superior to single-dose antibiotic prophylaxis (345 patients) in preventing SSI after implant-based breast reconstruction.

The researchers found that within six months, 4.3 percent of patients had their implant removed because of SSI, while readmission for intravenous antibiotics because of SSI occurred in 7 percent of women. More than one-quarter of women (27.7 percent) received oral antibiotics because of clinically suspected SSI. For implant removal, there was no significant difference observed between the randomization groups. Similarly, there was no difference between the groups for readmission for intravenous antibiotics or prescription of oral antibiotics. The multiple-dose group had more adverse events associated with antibiotic treatment than the single-dose group.

“Multiple-dose intravenous antibiotic prophylaxis is not superior to a single-dose regimen in preventing postoperative infection after implant-based breast reconstruction and is not recommended because of the associated higher rates of adverse events,” the authors write.