Evaluating Antibiotic Prophylaxis in Breast Cancer SurgeryAn Experience of Post-COVID Era

Abstract

Background: The role of prophylactic antibiotics in reducing surgical site infections (SSI) and improving wound healing after breast cancer surgery remains debated. This study assessed the effectiveness of a single preoperative dose of amoxicillin–clavulanic acid on postoperative infection rates and wound outcomes. Objective: To evaluate the impact of prophylactic antibiotics on the frequency of surgical site infections in breast cancer surgery. Methods: A quasi-experimental study was conducted on 180 patients undergoing breast cancer surgery at Khyber Teaching Hospital, Peshawar. Demographic variables, BMI, ASA classification, comorbidities, tumor receptor status, type of surgery, antibiotic use, COVID-19 infection history, and vaccination status were recorded. Postoperative wound outcomes were assessed on Day 7 and Day 14. Statistical associations were analyzed using chi-square tests, with p<0.05 considered significant. Results: The mean age was 48.2 ± 10.15 years, and mean BMI was 21.9 ± 1.88. Most patients were ASA I (55%) or ASA II (40%). Comorbidities were present in 45.8%, predominantly hypertension and diabetes. Antibiotic use showed significant associations with age, BMI, type of surgery, ER/PR/HER2 status, and comorbidities (p<0.001). Patients receiving prophylactic antibiotics had significantly fewer postoperative complications at Day 7 and Day 14 (p<0.001). COVID-19 positivity was also significantly associated with higher infection rates (p<0.001). Conclusion: Prophylactic antibiotic use was associated with reduced postoperative complications and SSI in breast cancer surgery. However, concerns regarding antimicrobial resistance highlight the need for judicious antibiotic use and further research into patient-specific prophylactic strategies.

Keywords: Prophylactic antibiotics, Surgical Site Infection (SSI), breast cancer surgery, COVID-19, randomized allocation, quasi-experimental study.