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Tissue Expander Breast Reconstruction Infections in Penicillin-Allergic Patients
Zachary A. Koenig, BS
Luis Quiroga, MD, MPH
Lundrim Marku, BS
Logan Welch, BS
Joshua T. Henderson, MD
Kerri M. Woodberry, MD, MBA
Sebastian M. Brooke, MD
West Virginia University School of Medicine
2022-01-14
Presenter: Zachary A. Koenig
Affidavit:
To whom It may concern:
This research has not been published elsewhere and not presented at a major meeting.
Kerri Woodberry, MD, MBA, FACS
Director Name: Kerri Woodberry
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Breast (Aesthetic and Recon.)
Introduction:
Alternatives to cephalexin are frequently given for perioperative antibiotics in penicillin allergic patients. These regimens may not be as effective. The aim of this study is to evaluate whether penicillin allergic patients experience higher rates of infections in tissue expander breast reconstruction than penicillin non-allergic patients.
Methods:
This was a retrospective review of consecutive patients who underwent breast reconstruction with tissue expander placement between 1/1/2010 and 12/31/2018. Demographic data was collected, and infectious complication rates were compared between patients with and without penicillin allergies. Infection-related complications were defined as those infections requiring re-admission for intravenous antibiotics or reoperation.
Results:
One-hundred fifty-three (153) patients were included in the review. Thirty-five (35) had a penicillin allergy and received alternative perioperative antibiotic coverage. Penicillin-allergic and non-allergic groups were similar in average age at operation (49.3 versus 49.1, respectively), body mass index (29.1 kg/m2 versus 29.5 kg/m2, respectively), smoking status (5.71% versus 6.78% current smokers), and diabetes ( % vs % patients with diabetes diagnosis ). Infection-related complications occurred in 45.7% of penicillin-allergic patients and 28.0% of those without penicillin allergies (p=0.048). Infection resulted in premature explantation of a tissue expander in 25.7% of penicillin-allergic patients and 11.9% of controls (p=0.0441).
Conclusions:
In this population, penicillin-allergic patients experience significantly higher rates of infection-related complications than patients without penicillin allergies. This may be due to decreased effectiveness of alternative regimens due to dose timing or the community specific antibiogram.
