title: A randomized prospective study of prophylactic cloxacillin in breast reduction surgery.
abstract: BACKGROUND
  Postoperative infection after breast reduction surgery is a common complication, with the most commonly involved pathogen being Staphylococcus aureus. Previous studies of antibiotic prophylaxis in breast reduction surgery have been inconclusive. The aim of the present study was to clarify the role of prophylactic antibiotics in breast reduction surgery.
  
  
  METHODS
  In total, 325 women were randomized to antibiotic prophylaxis [with 2 g of cloxacillin intravenously (IV) or 600 mg of clindamycin IV] (intervention group) or no antibiotic prophylaxis (control group). Follow-up was conducted at 1 and 2 weeks postoperatively. Patients with signs of infections or other complications were followed up until resolution. Patients who received antibiotic treatment within 30 days from surgery (cloxacillin 750 mg or clindamycin 300 mg orally) were considered having an infection and this was the main outcome variable. All postoperative infections were also judged according to a graded scale.
  
  
  RESULTS
  In the intervention group, 26 (16.0%) patients were treated with antibiotic; and in the control group, 32 (19.6%) patients were treated with antibiotics. No difference was found between the groups (relative risk, 0.82; 95% confidence interval, 0.51-1.31; P = 0.49). Twenty-two (14%) patients in the intervention group were classified to have a possible infection according to the scale compared to 27 (17%) in the control group. No statistical difference was found (relative risk, 0.81; 95% confidence interval, 0.48-1.37; P = 0.54).
  
  
  CONCLUSIONS
  Prophylactic cloxacillin as a single-dose IV in breast reduction surgery does not reduce the incidence of postoperative infections.
authors.affiliation: From the Department of Plastic and Hand Surgery, Institute of Clinical Sciences, University of Göteborg, Sahlgrenska Academy, Sahlgrenska University Hospital, Göteborg, Sweden.
authors.forename: Richard
authors.initials: R
authors.lastname: Lewin
authors.forename: Anna
authors.initials: A
authors.lastname: Elander
authors.forename: Andri
authors.initials: A
authors.lastname: Thorarinsson
authors.forename: Lars
authors.initials: L
authors.lastname: Kölby
authors.forename: Per-Erik
authors.initials: PE
authors.lastname: Sahlin
authors.forename: Jonas
authors.initials: J
authors.lastname: Lundberg
authors.forename: Alexander
authors.initials: A
authors.lastname: Panczel
authors.forename: Mattias
authors.initials: M
authors.lastname: Lidén
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis; D002981:Clindamycin / Q000627:therapeutic use; D003023:Cloxacillin / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007275:Injections, Intravenous; D016462:Mammaplasty; D008875:Middle Aged; D011446:Prospective Studies; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000517:prevention & control*; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D002981:Clindamycin; D003023:Cloxacillin