Prophylactic antibiotics in aesthetic and reconstructive surgery.

Area of Science:

• Plastic Surgery
• Infectious Disease Prevention
• Antibiotic Stewardship

Background:

• Antibacterial prophylaxis is a frequent antibiotic use in hospitals, significantly impacting surgical practices over the last two decades.
• Understanding current patterns and rationale for antibiotic use in plastic surgery is crucial for optimizing antimicrobial stewardship.

Purpose of the Study:

• To investigate the current patterns and reasons for antibacterial agent prophylaxis among practicing plastic surgeons in Israel.
• To identify factors influencing the decision to prescribe prophylactic antibiotics in aesthetic and reconstructive surgeries.

Main Methods:

• A survey was conducted among 78 certified plastic surgeons in Israel.
• Questionnaires were mailed, with 66 (84.6%) returned and analyzed to determine antibiotic usage patterns and influencing factors.

Main Results:

• Prophylactic antibiotics are widely used in aesthetic and reconstructive surgeries, except for eyelid and nose procedures.
• Cephalosporins are the preferred antibiotic class, typically administered before or at the start of surgery.
• Conditions like diabetes mellitus, steroid treatment, and chronic lung disease influence antibiotic prophylaxis decisions, while personal experience is the primary driver for prescribing.

Conclusions:

• Despite low surgical site infection rates, a high percentage of Israeli plastic surgeons administer prophylactic antibiotics.
• The decision to use prophylactic antibiotics is largely based on personal experience rather than robust scientific data.
• Further research is needed to establish evidence-based guidelines for antibiotic prophylaxis in plastic surgery.