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Prevention of surgical site infection after breast cancer surgery by targeted prophylaxis antibiotic in patients at high risk of surgical site infection
Author(s) -
Nicolas Penel,
Yazdan Yazdanpanah,
MariePierre Chauvet,
Stéphanie Clisant,
Sylvia Giard,
JeanCharles Neu,
Danièle Lefebvre,
Charles Fournier,
Jacques Bonneterre
Publication year - 2007
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.20796
Subject(s) - medicine , antibiotic prophylaxis , breast cancer , odds ratio , surgery , incidence (geometry) , confidence interval , cohort , cohort study , prospective cohort study , logistic regression , confounding , cancer , antibiotics , physics , optics , microbiology and biotechnology , biology
Objective We previously showed that previous chemotherapy and immediate breast reconstruction were associated with an increased risk of surgical site infection (SSI) in patients undergoing breast cancer surgery. The present before–after study evaluated a preventive strategy for high‐risk patients. Patients and Methods We compared the incidence of SSI in two prospective observational cohorts of patients underwent clean procedure in curative intent for a‐biopsy proven breast cancer: a historical cohort followed before implementation of a preventive strategy and a second cohort followed thereafter. The strategy consisted of identifying patients at risk of SSI and prophylaxis administration of cefuroxime to those patients. The impact of our strategy was analyzed using a logistic regression model adjusted for potential confounders. Results SSI incidence was estimated at 19/542 (3.5%) before preventive strategy versus 2/247 (0.8%) thereafter (crude odds ratio (OR) 0.22 confidence interval [95% CI 0.05–0.97], P = 0.03). After adjustment for confounders (breast reconstruction, previous breast surgery, and duration of surgery), our preventive strategy reduced the risk of SSI by 81% (adjusted OR 0.19 [95% CI 0.04–0.85], P = 0.03). Conclusion These results showed that antibiotic prophylaxis is beneficial for patients at high‐risk of WI after breast cancer surgery. Randomized controlled trials should now confirm these findings. J. Surg. Oncol. 2007;96:124–129. © 2007 Wiley‐Liss, Inc.