Levofloxacin for prophylaxis in breast cancer surgery compared with ofloxacin

BACKGROUND: We found that once-daily use of ofloxacin is beneficial from the standpoints of economy and patient compliance. Levofloxacin, has twice the antimicrobial activity and same toxicity of ofloxacin. We investigated the clinical usefulness of levofloxacin compared with ofloxacin in breast surgery. METHOD: Between July, 1996 and April, 1999, 199 consecutive patients hospitalized in our department for treatment of breast cancer were enrolled in this study with their informed consent and 181 patients were evaluated. RESULTS: Four (4%) of the 99 patients in the levofloxacin group had wound infections, as did 5 (6%) of the 82 patients in the ofloxacin group. The median times needed for wound care, with 25th and 75th percentiles, were 13 9, 16] days in the levofloxacin group and 11 9, 16] days in the ofloxacin group. From infected wound three strains of Staphylococcus aureus were detected from the levofloxacin group and two strains were from ofloxacin group, but no methicillin-resistant strains were isolated. Multiple regression analysis showed that only wound dehiscence was a significant factor in the occurrence of wound infection and the period of wound care. No signs or symptoms suggesting levofloxacin or ofloxacin toxicity were observed. Laboratory test changes before and after treatment were similar in the two groups. CONCLUSION: It appears that levofloxacin is not superior to ofloxacin in prophylactic efficacy for postoperative wound infection after breast surgery.