Do Prolonged Prophylactic Antibiotics Reduce the Incidence of Surgical Site Infections in Immediate Prosthetic Breast Reconstruction?.

Background: Approximately 50,000 women per year in the United States undergo mastectomy and immediate prosthetic breast reconstruction, and most will receive prolonged prophylactic antibiotics. The effect of this practice on the risk of surgical site infections (SSIs) remains unclear. Methods: We searched the Medline, Embase, and Cochrane Library databases for studies that compared 24 hours of antibiotics in cases of immediate prosthetic breast reconstruction. The primary outcomes were SSIs and implant loss. Conservative random effects models were used to obtain pooled relative risk (RR) estimates. Results: We identified 927 studies, but only 4 cohort studies and 1 randomized controlled trial (RCT) met our inclusion criteria. There was significant heterogeneity between studies. The unadjusted incidences of SSIs were 14% with >24 hours of antibiotics, 19% with 24 hours of antibiotics, 10% with

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