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Establishment of a Clinic-based Biorepository

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Published on: May 29, 2017

Antibiotic Practices in Mohs Micrographic Surgery.

Matthew J Lin, Danielle P Dubin, Cerrene N Giordano

Journal of Drugs in Dermatology : JDD

|June 3, 2020

Summary

Mohs surgeons show varied antibiotic prescribing habits. While many avoid routine antibiotics, disparities exist in high-risk cases, potentially leading to infections or overuse.

Area of Science:

Dermatology
Surgical Oncology
Infectious Disease

Background:

Mohs micrographic surgery is a widely used dermatologic procedure known for its high cure rates and safety.
Infection is a known complication, though rates are generally low.

Purpose of the Study:

To investigate and document the current antibiotic prescribing patterns among Mohs surgeons in the United States.
To identify potential variations and areas for guideline improvement in antibiotic prophylaxis.

Main Methods:

A 16-question survey was distributed to members of the American College of Mohs Surgery.
Data were collected from 305 respondents, representing over 7,634 years of collective surgical experience.

Main Results:

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The majority of Mohs surgeons avoid routine oral or topical antibiotics for standard procedures.
Prophylactic antibiotics are frequently used for specific high-risk indications including artificial cardiac valves, anogenital surgery, and immunosuppression.
A minority of surgeons routinely screen for and decolonize Staphylococcus aureus carriers.

Conclusions:

Significant variability exists in antibiotic prescribing practices for Mohs surgery.
Potential under-prescription for certain high-risk procedures (e.g., nasal flaps, grafts) and over-prescription for others (e.g., prosthetic joints) were noted.
Enhanced adherence to evidence-based guidelines may optimize antibiotic use, reduce post-operative infections, and mitigate adverse effects and costs.