Decreasing Antibiotic and Surgical Site Infections in Reconstructive Breast Surgery: Results from a 2015 to 2022 National Evaluation

 

The American Association of Plastic Surgeons recommends perioperative antibiotic prophylaxis for patients undergoing clean cosmetic breast surgery. There are currently no guidelines for prophylactic postoperative antibiotics for those undergoing breast reduction or post-mastectomy reconstruction. This study aims to evaluate trends in antibiotic use in the postoperative period >48 hours after reduction mammaplasty or postmastectomy reconstruction and evaluate factors associated with surgical site infection.

 

Joseph N. Fahmy, MD, MS 1,2; Jacob S. Nasser, MD1; Hao Wu, MS3; Lu Wang, PHD3; Kevin C. Chung, MD, MS1

1.Section of Plastic Surgery, Department of Surgery, University of Michigan Medical School, Ann Arbor, MI, USA

2. Division of Plastic Surgery, Department of Surgery, Loyola University Medical Center, Maywood, IL, USA

3. Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI, USA

 

Source: Meritive Marketscan, a large national employer sponsored insurance claims dataset from 2015 to 2022

 

Antibiotic use decreased throughout the study period.

 

Antibiotic use past 48h was associated with lower infection risk among propensity weighted patients while greater comorbidity burden was associated with both higher risk of infections and increased odds of antibiotic use.

 

These data suggest guidelines on antibiotic use postoperatively must consider patient comorbidity burden and tailoring antibiotic use and encourage antibiotic stewardship.