Long-acting versus short-acting cephalosporins for preoperative prophylaxis in breast surgery: A randomized double-blind trial involving 1,766 patients

Postoperative infectious complications after breast surgery may result in s ignificant morbidity, psychological trauma, and additional costs. We assess ed the efficacy of preoperative antibiotic prophylaxis for surgery in a ran domized, double-blind trial of 1,766 patients undergoing breast surgery. Fr om January 1, 1996 to August 31, 1997, all eligible patients were assigned randomly to receive a single dose of ceftriaxone (2 g) or ceftazidime (2 g) given intravenously at the induction of anesthesia, with no further doses. The groups were similar with respect to age, operative procedure, operativ e time and time to discharge after operation. The patients who received cef triaxone prophylaxis had 54.4% fewer overall infections than those who rece ived ceftazidime prophylaxis. Wound infection occurred in 0.45% of the ceft riaxone recipients (2 of 883) and 0.91% of the ceftazidime recipients (8 of 883). This prospective randomized double-blind study showed that the long- acting regimen containing ceftriaxone is more cost-effective than the short -acting ceftazidime in preventing postoperative infections in patients subj ected to breast surgery.