{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T04:19:04Z","timestamp":1778127544552,"version":"3.51.4"},"reference-count":38,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2025,7,21]],"date-time":"2025-07-21T00:00:00Z","timestamp":1753056000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,10,16]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Extended prophylactic antibiotic (EPA) regimens are commonly used following implant- or tissue expander-based breast reconstruction, although their efficacy in preventing infection-related complications remains unclear. The authors of this systematic review and meta-analysis evaluated whether EPA use (&amp;gt;48\u2005h postoperatively) reduces surgical site infections, explantation, or reoperation events compared with short-course antibiotic regimens (\u226448\u2005h). A comprehensive search of 4 databases was conducted through May 2025, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Sixteen studies were included, comprising 8173 patients in the EPA group and 2676 in the non-EPA group. Outcomes assessed included overall, minor, and major infections, as well as explantation and reoperation rates. Risk ratios (RRs) with 95% CIs were calculated, and study quality was evaluated using the Downs and Black checklist. No statistically significant differences were found between groups for overall infection (RR 0.90, 95% CI, 0.75-1.06), minor infection (RR 0.62, 95% CI, 0.28-1.33), major infection (RR 0.83, 95% CI, 0.50-1.38), explantation (RR 0.77, 95% CI, 0.46-1.30), or reoperation (RR 1.17, 95% CI, 0.78-1.78). These findings suggest that EPA does not confer additional clinical benefit in reducing postoperative complications following implant-based breast reconstruction. In light of the known risks associated with prolonged antibiotic use\u2014including gastrointestinal disturbances, Clostridium difficile infection, and antibiotic resistance\u2014these results support more judicious, evidence-based prescribing practices. The authors of this study provide updated evidence to inform antibiotic stewardship efforts and standardize care in breast reconstruction.<\/jats:p>\n               <jats:p>Level of Evidence: 3 (Risk)<\/jats:p>\n               <jats:p\/>","DOI":"10.1093\/asj\/sjaf144","type":"journal-article","created":{"date-parts":[[2025,7,21]],"date-time":"2025-07-21T05:59:24Z","timestamp":1753077564000},"page":"1152-1158","source":"Crossref","is-referenced-by-count":3,"title":["Extended Antibiotic Prophylaxis in Implant-Based Breast Reconstruction: A Systematic Review and 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