title: Prevention of surgical site infection after breast cancer surgery by targeted prophylaxis antibiotic in patients at high risk of surgical site infection.
abstract: 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.
  
  
  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).
  
  
  CONCLUSIONS
  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.
authors: Département de Cancérologie Générale, Centre Oscar Lambret, France. n-penel@o-lambret.fr
authors: Nicolas
authors: N
authors: Penel
authors: Penel
authors: P
authors: Nicolas
authors: Yazdan
authors: Y
authors: Yazdanpanah
authors: Yazdanpanah
authors: Y
authors: Yazdan
authors: Marie-Pierre
authors: MP
authors: Chauvet
authors: Chauvet
authors: C
authors: Marie-Pierre
authors: Stéphanie
authors: S
authors: Clisant
authors: Clisant
authors: C
authors: Stéphanie
authors: Sylvia
authors: S
authors: Giard
authors: Giard
authors: G
authors: Sylvia
authors: Jean-Charles
authors: JC
authors: Neu
authors: Neu
authors: N
authors: Jean-Charles
authors: Danièle
authors: D
authors: Lefebvre
authors: Lefebvre
authors: L
authors: Danièle
authors: Charles
authors: C
authors: Fournier
authors: Fournier
authors: F
authors: Charles
authors: Jacques
authors: J
authors: Bonneterre
authors: Bonneterre
authors: B
authors: Jacques
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis; D001943:Breast Neoplasms / Q000532:radiotherapy / Q000601:surgery*; D018567:Breast Neoplasms, Male / Q000601:surgery; D002444:Cefuroxime / Q000627:therapeutic use*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D011787:Quality of Health Care; D018570:Risk Assessment; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000517:prevention & control*
chemical_list: D000900:Anti-Bacterial Agents; D002444:Cefuroxime