Main Article Content


Surgical operations on modified radical mastectomy are considered clean procedures by the Centers for Disease Control and Prevention (CDC) wound classification system. Despite this, higher than expected Surgical Site Infection (SSI) rates are reported, varying from 1 % to 26 % across the literature. Some surgeons also prescribe postoperative prophylaxis for postoperative modified radical mastectomy patients to prevent infection despite its lack of proven efficacy. The aim of this study is to analyze the use of oral antibiotics to prevent Surgical Site Infection (SSI) on postoperative modified radical mastectomy patients in Dr. Soetomo General Hospital. This study was double-blinded randomized control trial of 60 postoperative modified radical mastectomy patients (2 groups) during the period of December 2017 to March 2018. Samples were prospectively divided into two groups (random sampling), in group A (n=30) patients received single dose prophylactic antibiotics and continued with oral antibiotics postoperative (Cefadroxil 2 x 500 mg) during 7 days and in group B (n=30) patients received single dose prophylactic antibiotics and continued without postoperative antibiotics (placebo). Both groups were evaluated clinically for surgical site infection up to 30 days. There was no statistically significant difference in both groups {p=1 (p>0.05)}. There was no incidence of surgical site infection in both groups during the 30-day follow-up period (days 3, 7, 14 and 30). There was no difference in the surgical site infection rate among those who received oral postoperative antibiotics prophylactic and without antibiotics (placebo) on postoperative modified radical mastectomy patients in Dr. Soetomo General Hospital. Because of the potential adverse events associated with antibiotic use, further evaluation of this practice is required.


Oral antibiotics surgical site infection postoperative modified radical mastectomy patients

Article Details

How to Cite
Hadi, N., & Ishardyanto, H. (2020). The Use of Oral Antibiotics to Prevent Surgical Site Infection on Postoperative Modified Radical Mastectomy Patients in Dr. Soetomo General Hospital, Surabaya. Folia Medica Indonesiana, 56(1), 36–40.


  1. Angarita FA, Acuna SA, Torregrosa L, Tawil M, Escallon J, Ruı´z A (2011). Perioperative variables associated with surgical site infection in breast cancer surgery. J Hosp Infect 79, 328-32
  2. Brahmbhatt RD, Huebner M, Scow JS, et al (2012). National practice patterns in preoperative and postoperative antibiotic prophylaxis in breast procedures requiring drains: survey of the American Society of Breast Surgeons. Ann Surg Oncol. doi: 10.1245/ s10434-012-2477-1
  3. Bunn F, Jones DJ, Bell-Syer S (2012). Prophylactic antibiotics to prevent surgical site infection after breast cancer surgery. Cochrane Database Syst. Rev, CD005360. doi: 10. 1002/14651858.CD005360
  4. Degnim AC, Scow JS, Hoskin TL, et al (2013). Randomized controlled trial to reduce bacterial colonization of surgical drains after breast and axillary operations. Ann Surg 258, 240-7
  5. Edwards BL, Stukenborg GJ, Brenin DR, Schroen AT (2014). Use of prophylactic postoperative antibiotics during surgical drain presence following mastectomy. Annals of surgical oncology 21, 3249-3255. doi:10. 1245/s10434-014-3960-7
  6. Felippe WAB, Werneck GL, Santoro-Lopes G (2007). Surgical site infection among women discharged with a drain in situ after breast cancer surgery. World J Surg 31, 2293-9
  7. Hedrick TL, Smith PW, Gazoni LM, Sawyer RG (2007). The appropriate use of antibiotics in surgery: a review of surgical infections. Curr Probl Surg 44, 635-75
  8. Pedoman Penggunaan Antibiotika di Bidang Bedah (2009). Department of Surgery, Faculty of Medicine, Universitas Airlangga/dr. Soetomo Hospital, Surabaya
  9. Sajid MS, Hutson K, Akhter N, Kalra L, Rapisarda I, Bonomi R (2012). An updated meta-analysis on the effectiveness of preoperative prophylactic antibiotics in patients undergoing breast surgical procedures. Breast J 18, 312-7
  10. Specifications Manual for Joint Commission National Quality Core Measures (2010).
  11. The American Society of Breast Surgeons (2012). Position statement on antibiotics and surgical site infection
  12. Throckmorton AD, Boughey JC, Boostrom SY, et al (2009). Postoperative prophylactic antibiotics and surgical site infection rates in breast surgery. Ann Surg Oncol 16, 2464-9
  13. Vilar-Compte D, Jacquemin B, Robles-Vidal C, Volkow P (2004). Surgical site infections in breast surgery: case-control study. World J Surg 28, 242-6. doi: 10.1007/s00268-003-7193-3
  14. WHO guidelines for safe surgery (2009). Safe surgery saves lives