piperacillin--tazobactam-drug-combination and Breast-Neoplasms

Although antibiotic prophylaxis is not explicitly indicated for hernia repair and breast surgery, its use for these clean procedures is widely adopted, albeit to a different extent in different countries, often on the personal decision of the individual surgeon. The present study was carried out to compare the efficacy of a single pre-operative dose of piperacillin-tazobactam with placebo in preventing surgical wound infections and to determine the main risk factors associated with infections following two main elective surgical clean procedures such as hernia repair and breast surgery.A total of 501 patients undergoing elective inguinal/femoral hernia repair or breast surgery were enrolled in this prospective randomized clinical study. Patients were randomly assigned to receive preoperative antibiotic prophylaxis or placebo. One dose of piperacillin-tazobactam 2.250 g or placebo was administered i.v. 30 minutes prior to the surgical procedure. Using statistical univariate analysis, the following variables were correlated with a higher infection risk: age >40 years, concomitant disease, WBC <3500, surgical wound size >9cm, use of drainages, non-prophylaxis. Using multivariate analysis, no antibiotic pre-operative prophylaxis, concurrent chronic diseases, especially diabetes (risk 15 times higher), and length of intervention >45 min (risk 6 times higher) were independent predictors of infection. Finally, patients with postoperative infections had a significantly longer hospitalisation. One pre-operative dose of piperacillin-tazobactam 2.250 g is more effective than placebo in preventing postoperative infections in breast surgery and hernia repair.

Topics: Age Factors; Anti-Bacterial Agents; Antibiotic Prophylaxis; Breast Neoplasms; Double-Blind Method; Drainage; Female; Herniorrhaphy; Humans; In Vitro Techniques; Lymph Node Excision; Male; Mastectomy; Middle Aged; Penicillanic Acid; Piperacillin; Piperacillin, Tazobactam Drug Combination; Prospective Studies; Sex Factors; Surgical Wound Infection; Time Factors

Topics: Acute Kidney Injury; Administration, Intravenous; Administration, Oral; Adult; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Antineoplastic Combined Chemotherapy Protocols; Breast Neoplasms; Chemotherapy-Induced Febrile Neutropenia; Chemotherapy, Adjuvant; Cyclophosphamide; Doxorubicin; Female; Fluoroquinolones; Hospitalization; Humans; Medical Overuse; Neoplasm Staging; Piperacillin, Tazobactam Drug Combination; Risk Assessment; Vancomycin

Topics: Aged; Alcaligenes faecalis; Bacteremia; Bordetella; Bordetella Infections; Breast Neoplasms; Catheter-Related Infections; Coinfection; Female; Gram-Negative Bacterial Infections; Humans; Immunocompromised Host; Neoplasm Metastasis; Piperacillin, Tazobactam Drug Combination