Single-Dose versus 24-Hour Antibiotic Prophylaxis in Reduction Mammaplasty: A Randomized Controlled Trial.

BACKGROUND

This trial was performed to compare the influence of administering a single dose or 24 hours of prophylactic antibiotics on surgical-site infection (SSI) rates after reduction mammaplasty.

METHODS

This was a randomized, noninferiority, parallel-arm clinical trial with a 1:1 allocation ratio. A total of 146 participants undergoing reduction mammaplasty were randomly assigned to the placebo group, which received 1 g of cefazolin at the time of anesthesia induction ( n = 73), or the antibiotic group, which received 1 g of cefazolin at the time of anesthesia induction and every 6 hours for 24 hours ( n = 73). No antibiotics were prescribed to any of the participants after this period. SSI occurrence was evaluated using criteria and definitions from the Centers for Disease Control and Prevention. The participants were assessed weekly for 30 days by a surgeon blinded to group allocation.

RESULTS

There were no significant differences between the groups in terms of main characteristics. Among the 146 participants, median age was 33 years; body mass index, 25.2 Kg/m²; weight of excised breast tissue, 925 g; and surgery time, 220 minutes. Superficial dehiscence occurred in 30 patients (20.5%): 16 in the placebo group and 14 in the antibiotic group ( P = 0.682). Eight participants (5.5%) had SSI, with 4 in each group ( P = 1.000). In all cases, SSI was classified as superficial incisional.

CONCLUSION

The results of this study suggest that extending antibiotic prophylaxis beyond a single dose administered during anesthesia induction does not significantly reduce the incidence of SSIs or wound dehiscence in reduction mammaplasty.

CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, I.