Journal Scan / Research · February 21, 2018

Rate of Surgical Site Infections With New Protocol of Prophylactic Antibiotic Use

Dermatologic Surgery

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In this retrospective study, the authors evaluated the rate of surgical site infections at a single institution using a formal protocol for the use of prophylactic antibiotics. This protocol involved administering prophylactic antibiotics 30 to 60 minutes before the procedure to patients deemed to be at greater than 5% risk for infection, including those with surgeries in the groin, below the knee, wedge excisions of the lip or ear, or procedures involving perforation of the oral mucosa. Skin grafts were excluded from the study. The infection rate among high-risk patients receiving prophylactic antibiotics was 0.83%, and the infection rate among low-risk patients not receiving prophylactic antibiotics was 0.71%.
As the infection rates in the dermatologic surgery are low, administering prophylactic antibiotics only to those patients with an increased risk for infection may help reduce the risks of unnecessary antibiotic use.
– Jeffrey F. Scott, MD

Abstract

Randomized double-blind studies for antibiotic use in dermatologic surgery are lacking, so guidelines are extrapolated from other fields. As a result, prophylactic antibiotic use varies among dermatologic surgeons and some studies report widespread use. However, antibiotic use is not without consequences. Moreover, in most cases, antibiotics may not be necessary as infection rates in dermatologic surgery are low (0.07%–4.25%).