Guidelines for Complications of Cancer Treatment Vol VIII Part B

eduction mammoplasty, and axillary-node dissection. Theprophylactic regimen was a single dose of cefonicid (1 gintravenously) administered approximately half an hour beforesurgery. The patients were followed up for four to six weeksafter surgery. Blinding was maintained until the last patientcompleted the follow-up and all diagnoses of infection hadbeen made. The patients who received prophylaxis had 48percent fewer probable or definite infections than those whodid not (Mantel-Haenszel risk ratio, 0.52; 95 percentconfidence interval, 0.32 to 0.84; P = 0.01). For patientsundergoing a procedure involving the breast, infectionoccurred in 6.6 percent of the cefonicid recipients (20 of 303)and 12.2 percent of the placebo recipients (37 of 303); forthose undergoing herniorrhaphy, infection occurred in 2.3percent of the cefonicid recipients (7 of 301) and 4.2 percentof the placebo recipients (13 of 311). There were comparablereductions in the numbers of definite wound infections(Mantel-Haenszel risk ratio, 0.49), wounds that drained pus(risk ratio, 0.43) Staphylococcus aureus wound isolates (riskratio, 0.49), and urinary tract infections (risk ratio, 0.40). Therewere also comparable reductions in the need for postoperativeantibiotic therapy, non-routine visits to a physician forproblems involving wound healing, incision and drainageprocedures, and readmission because of problems with woundhealing. We conclude that perioperative antibiotic prophylaxiswith cefonicid is useful for herniorrhaphy and certain types ofbreast surgery.PMID: 2403655 [PubMed - indexed for MEDLINE]7. Antibiotic prophylaxis for post-operative woundinfection in clean elective breast surgery.Gupta R, Sinnett D, Carpenter R, et al. Eur J Surg Oncol.2000 Jun;26(4):363-6.Antibiotic prophylaxis has been used to good effect in theprevention of post-operative wound infections in patients16