Is a 10 day course of Keflex necessary for prophylaxis after breast augmentation?

Question

IV antibiotics were given during procedure as well. With so many treatment resistant bugs and risks for c. Diff I question it. Additionally the script doesn't really even indicate how long to take it. It just says 4x per day. There are 40 pills and 1 refill. Is this practicing safe medicine?

Nelson Castillo, MD · Answer

Thank you for your question and I can appreciate your desire to minimize your own risk of side effects from antibiotic use.  Each surgeon will have their own recommendations for prophylaxis after surgery though no study has conclusively shown any benefit in its use.  The antibiotic just prior to surgery is associated with less complications and is recommended.  Speak to your surgeon now or at your follow-up appointment to voice your concerns.  They can then explain their rationale for antibiotic use.  Hope this helps.

John Mesa, MD · Answer

Antibiotic prophylaxis after breast augmentation is recommended to prevent infection and down the road development of capsular contraction.The length of antibiotic prophylaxis has not been standardized. Some surgeons suggest as short as few days. Others recommend 5, 7 10 and up to 14 days of antibiotics.

Karol A. Gutowski, MD, FACS · Answer

There is no evidence that antibiotics are needed beyond 24 hours after surgery if they were given at the start of surgery and the procedure was done in a sterile way and without drains. Discuss your concerns with your surgeon as the risk of a C Diff infection is real.

Robert H. Hunsaker, MD · Answer

There is pretty good science out that shows all that is really necessary is the single intraoperative dose in breast augmentation provided it is administered between 30 and 60 minutes prior to incision. Many surgeons administer more. For instance, even though I know the data says it is "unnecessary", I give three doses (one every eight hours) after surgery. Maybe one day I will stop that as well.

Steven Wallach, MD · Answer

Every surgeon is a bit different. Some use one dose, some use several days, and some recommend longer. Best to review with your surgeon.

John S. Alspaugh, MD, FACS · Answer

Receiving antibiotics after the first day or so after an augmentation probably does not protect against a wound infection. Capsular contracture is a complication that might be associated with non disease causing bacteria. No broadly accepted standards in regards to antibiotics for the prevention of this complication exist. Discuss your concerns with your Plastic Surgeon.

Tom J. Pousti, MD · Answer

You may wish to clarify with your plastic surgeon but, to the best of my knowledge,  the use of postoperative of antibiotics have not been shown to  provide prophylaxis against anything.   On the other hand, the initial use of intravenous antibiotics is helpful. Best wishes for an outcome that you will be very pleased with.

James McMahan, MD (retired) · Answer

Thank you for your thoughtful question. An IV dose before surgery and 10 days or oral keflex is clearly excessive and certainly does put you at risk for c. diff.  A few days is OK, but I would not take it for 10 days.

Is a 10 day course of Keflex necessary for prophylaxis after breast augmentation?

Answers (8)

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