Prospective, randomized, double blind study of prophylactic antibiotics in axillary lymph node dissection

BACKGROUND: Antibiotic prophylaxis is controversial in patients undergoing axillary lymph node dissection (ALND), We determined whether preoperative antibiotics decreased incidence or treatment cost of infectious complications following ALND, METHODS: TWO hundred patients entered this prospective, randomized, double-blind trial. Patients received either placebo or cefonicid preoperatively, Loco-regional signs of infection were monitored for 4 weeks postoperatively, RESULTS: There was a trend toward fewer infections in the prophylactic group (placebo 13% versus cefonicid 6%; P = 0.080), Cefonicid significantly decreased severe infections requiring hospitalization (placebo 8% versus cefonicid 1%; P = 0.033). Cefonicid also decreased the treatment cost of infection per patient ($49.80 versus $364.87), CONCLUSIONS: We demonstrated a trend toward fewer overall infections and significantly fewer severe infections in patients given prophylactic antibiotics, which translated into a decrease in the cost of treatment for infectious complications. These findings support antibiotic prophylaxis for patients undergoing ALND, (C) 1998 by Excerpta Medica, Inc.