Louis, Missouri: Anti methicillin-sensitive Staphylococcus aureus (MSSA) antibiotics were related to a lower incidence of surgical-site infection (SSI) in patients who had a mastectomy alone and those who had a mastectomy with rapid reconstruction, according to recent research. Following a mastectomy, preventive antibiotics were commonly prescribed. Despite guidelines advising against it, prophylactic antibiotics are frequently administered at the time of discharge from a mastectomy.
The researchers evaluated variables related to post-discharge prophylactic antibiotic usage following mastectomy with and without rapid reconstruction, as well as the influence on surgical-site infection in this study (SSI). This work was conducted by David K. Warren and the team and the findings of this study were published in Cambridge University Press on 27th September 2021.
It was a group of women between the ages of 18 and 64 who had a mastectomy between January 1, 2010, and June 30, 2015, according to the MarketScan commercial database. Patients with nonsurgical perioperative infections were not included in the study. Outpatient medication claims were used to identify post-discharge oral antibiotics. The International Classification of Diseases, Ninth Edition, Clinical Modification (ICD-9-CM) diagnostic codes were used to describe SSI. Factors related to post-discharge prophylactic antibiotic usage and SSI were identified using generalized linear models.
There were 38,793 operations in the group, with 24,818 (64%) requiring rapid reconstruction. The 90-day incidence of SSI after mastectomy alone was 3.5%, and 8.8% following mastectomy with rapid reconstruction. Antibiotics with anti–methicillin-sensitive Staphylococcus aureus (MSSA) action were linked to a lower incidence of SSI following mastectomy alone and mastectomy with rapid reconstruction, respectively. The treatment numbers required to prevent one new SSI were 107 and 48, respectively. Anti-MSSA drugs, according to the authors, are linked with a moderate incidence of Clostridioides difficile infection and other side effects ranging from rashes to more serious events such as allergy and acute renal failure.
Finally, they stated that the little apparent advantage of post-discharge oral antibiotics should be weighed against the dangers associated with antibiotic misuse, especially considering the comparatively high number of women who would need to be treated to avoid one infection.
Reference:
Warren, D. K., Peacock, K. M., Nickel, K. B., Fraser, V. J., & Olsen, M. A. (2021). Postdischarge prophylactic antibiotics following mastectomy with and without breast reconstruction. Infection Control & Hospital Epidemiology, 1–7. https://doi.org/10.1017/ice.2021.400