Complications associated with postoperative antibiotic prophylaxis after breast surgery

Background: Evidence supports single-dose preoperative antibiotic (ABX) prophylaxis for breast surgery; however, limited data exist regarding the incidence and type of antibiotic complications postoperatively. Methods: Breast/axillary surgeries between July 2004 and June 2006 were reviewed. Complications were analyzed by antibiotic group: preoperative prophylaxis, postoperative prophylaxis, and therapeutic intent. The Fisher exact test was used to compare complication rates. Results: A total of 389 patients underwent breast/axillary surgeries during the study period. A total of 363 (93%) patients received ABX: 353 (91%) received a single preoperative dose, 91 (23%) received postoperative ABX prophylaxis, and 76 (201%) received ABX for therapeutic intent. Among patients receiving ABX, 15 (4%) had an ABX-related complication. The ABX-related complication rate was significantly higher among those receiving postoperative prophylaxis (5.5%; 5 of 91) compared with those receiving preoperative ABX alone (0%; 0 of 214) (P = .002). Conclusions: Drug-related complications were uncommon with preoperative ABX prophylaxis. Considering the potential complications of ABX after breast surgery, the use of postoperative prophylaxis should be reexamined.