Postoperative systemic antibiotic usage in elective eyelid surgery: is it really necessary?

Area of Science:

• Ophthalmology
• Oculoplastics
• Surgical Infections

Background:

• Prophylactic antibiotic use in oculoplastic surgery lacks clear guidelines.
• Indiscriminate antibiotic use may lead to individual harm and antimicrobial resistance.

Purpose of the Study:

• To investigate if avoiding systemic prophylactic antibiotics in elective lid surgeries increases surgical site infections (SSI).

Main Methods:

• A case-note audit compared patients receiving systemic and topical antibiotics versus topical antibiotics alone.
• Procedures included anterior ptosis repair and lateral tarsal strip (LTS) surgery.
• Data collected included American Society of Anesthesiologists (ASA) status, age, and SSI incidence at 2-week follow-up.

Main Results:

• No significant difference in age or ASA status between groups.
• SSI incidence was similar: 3 cases in the combined antibiotic group versus 2 in the topical-only group.
• The difference in SSI rates was not statistically significant (p = .7).

Conclusions:

• Avoiding systemic antibiotic prophylaxis for LTS and anterior ptosis repair is not linked to higher SSI rates.
• Routine systemic antibiotic use in these procedures offers no proven benefit and contributes to antimicrobial resistance.