Perioperative Antibiotic Use in Cutaneous Surgery
Hillary Johnson-Jahangir1, Neha Agrawal2
1Dermatology, University of Iowa, 200 Hawkins Drive, Iowa City, IA 52242, USA.
Dermatologic Clinics
|May 16, 2019
Summary
Oral antibiotics are often overused for skin and mucosal procedures. Current guidelines recommend them only for specific high-risk patients to prevent serious infections like endocarditis or joint infections, not for routine use.
Area of Science:
- Dermatologic surgery
- Infectious disease prevention
- Antibiotic stewardship
Background:
- Oral antibiotic prophylaxis is frequently overprescribed for procedures involving the integumentary system and mucosa.
- Limited evidence supports routine oral antibiotic use for preventing surgical site infections in these procedures.
Purpose of the Study:
- To evaluate the appropriate use of oral antibiotic prophylaxis in dermatologic surgery.
- To highlight the need for risk stratification and antibiotic stewardship in perioperative care.
Main Methods:
- Review of current literature and guidelines regarding antibiotic prophylaxis for dermatologic procedures.
- Analysis of indications for preoperative antibiotic prophylaxis for infective endocarditis and prosthetic joint infections.
Main Results:
- Oral antibiotic prophylaxis is not recommended for routine use in most dermatologic procedures.
- Prophylaxis is indicated only for specific high-risk patients undergoing procedures on infected or mucosal sites to prevent specific infections.
Conclusions:
- Appropriate perioperative oral antibiotic use requires careful risk stratification and adherence to antibiotic stewardship principles.
- Alternatives to oral antibiotics, such as wound antisepsis, should be considered to reduce infection risk.
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