Author(s): Ali Akhtar*, Soo Pei Yean, Amer Hayat Khan, Andee Dzulkarnaen Zakaria, Syed Hassan, Syed Azhar Syed Sulaiman
Staphylococcus aureus is often isolated in surgical site infection (SSI). The efficacy of prophylactic antibiotic in breast surgery has been addressed in several clinical trials. A 46-year-old Malay woman with right breast invasive ductal cancer and a history of gastritis for six years was admitted for right modified radical mastectomy with axillary clearance level II. Axillary drain had been continued for more than one week. Two days after the mastectomy, the patient presented with pus collection with haemoserrous discharge, despite treatment with Augmentin. Dressing was not soaked. Pus swab culture revealed Staphylococcus aureus sensitive to Cloxacillin, Erythromycin, Cotrimazole and Fusidic acid and resistant to Penicillin G. Tablet Cloxacillin 500 mg was given four times a day for wound infection. Appropriate selection of prophylactic antibiotic is important to reduce risk of infection.