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Open Access Research article

Determining the use of prophylactic antibiotics in breast cancer surgeries: a survey of practice

Sergio A Acuna15, Fernando A Angarita156, Jaime Escallon23, Mauricio Tawil14 and Lilian Torregrosa14*

Author affiliations

1 Department of Surgery, Hospital Universitario San Ignacio, Pontificia Universidad Javeriana, Bogotá, Colombia

2 Department of Surgery, University of Toronto, Toronto, ON, Canada

3 Department of Surgical Oncology, Princess Margaret Hospital, Toronto, ON, Canada

4 Breast and Soft Tissue Clinic, Centro Javeriano de Oncología, Bogotá, Colombia

5 Current address: Division of Experimental Therapeutics, Toronto General Research Institute, University Health Network, Toronto, ON, Canada

6 Current address: Institute of Medical Science, University of Toronto, Toronto, ON, Canada

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Citation and License

BMC Surgery 2012, 12:18  doi:10.1186/1471-2482-12-18

Published: 31 August 2012

Abstract

Background

Prophylactic antibiotics (PAs) are beneficial to breast cancer patients undergoing surgery because they prevent surgical site infection (SSI), but limited information regarding their use has been published. This study aims to determine the use of PAs prior to breast cancer surgery amongst breast surgeons in Colombia.

Methods

An online survey was distributed amongst the breast surgeon members of the Colombian Association of Mastology, the only breast surgery society of Colombia. The scope of the questions included demographics, clinical practice characteristics, PA prescription characteristics, and the use of PAs in common breast surgical procedures.

Results

The survey was distributed amongst eighty-eight breast surgeons of whom forty-seven responded (response rate: 53.4%). Forty surgeons (85.1%) reported using PAs prior to surgery of which >60% used PAs during mastectomy, axillary lymph node dissection, and/or breast reconstruction. Surgeons reported they targeted the use of PAs in cases in which patients had any of the following SSI risk factors: diabetes mellitus, drains in situ, obesity, and neoadjuvant therapy. The distribution of the self-reported PA dosing regimens was as follows: single pre-operative fixed-dose (27.7%), single preoperative dose followed by a second dose if the surgery was prolonged (44.7%), single preoperative dose followed by one or more postoperative doses for >24 hours (10.6%), and single preoperative weight-adjusted dose (2.1%).

Conclusion

Although this group of breast surgeons is aware of the importance of PAs in breast cancer surgery there is a discrepancy in how they use it, specifically with regards to prescription and timeliness of drug administration. Our findings call for targeted quality-improvement initiatives, such as standardized national guidelines, which can provide sufficient evidence for all stakeholders and therefore facilitate best practice medicine for breast cancer surgery.

Keywords:
Breast surgery; Surgical site infection; Prophylactic antibiotic