Prospective, randomized, double-blind study of prophylactic antibiotics in axillary lymph node dissection

Richard J. Bold, Paul F. Mansfield, David H. Berger, Raphael E. Pollock, S. Eva Singletary, Frederick C. Ames, Charles M. Balch, David C. Hohn, Merrick I. Ross

Research output: Contribution to journalArticlepeer-review


BACKGROUND: Antibiotic prophylaxis is controversial in patients undergoing axillary lymph node dissection (ALND). We determined whether preoperative antibiotics decreased incidence or treatment cost of infectious complications following ALND. METHODS: Two hundred patients entered this prospective, randomized, double-blind trial. Patients received either placebo or cefonicid preoperatively. Loco-regional signs of infection were monitored for 4 weeks postoperatively. RESULTS: There was a trend toward fewer infections in the prophylactic group (placebo 13% versus cefonicid 6%; P = 0.080). Cefonicid significantly decreased severe infections requiring hospitalization (placebo 8% versus cefonicid 1%; P = 0.033). Cefonicid also decreased the treatment cost of infection per patient ($49.80 versus $364.87). CONCLUSIONS: We demonstrated a trend toward fewer overall infections and significantly fewer severe infections in patients given prophylactic antibiotics, which translated into a decrease in the cost of treatment for infectious complications. These findings support antibiotic prophylaxis for patients undergoing ALND.

Original languageEnglish (US)
Pages (from-to)239-243
Number of pages5
JournalAmerican journal of surgery
Issue number3
StatePublished - Sep 1998
Externally publishedYes

ASJC Scopus subject areas

  • Surgery


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