Use of topical antibiotics as prophylaxis in clean dermatologic procedures

Topical antibiotic prophylaxis for prevention of surgical wound infections from dermatologic procedures: a systematic review and meta-analysis

“…Although use of topical antibiotics to prevent postsurgical wound infections in the dermatologic outpatient setting has decreased over the years, this practice should be eliminated completely (17). Since most wound infections occur as a result of contamination before wound closure, administering topical antibiotics postoperatively is not an effective measure to prevent postsurgical wound infections (34).…”

“…Topical antibiotics have been recognized as increasingly common causes of allergic contact dermatitis in USA, with neomycin being reported as the third most common contact allergen in the general patch test population of North America (17). A large study in which 3120 patients underwent patch testing demonstrated that neomycin caused an allergic reaction in 11.6% of patients, and bacitracin caused an allergic response in 9.1% of patients (42).…”

“…Continued use of topical antibiotics in practice by a considerable number of dermatologists has contributed to the already steadily increasing rates of antibiotic resistance (17). Reports of resistance in multiple different species of bacteria to commonly prescribed antibiotics have been reported, including Staphylococcus aureus, Staphylococcus epidermidis, Pseudomonas aeruginosa, Streptococcus pneumoniae and Propionibacterium acnes (37,47).…”

“…The perceived benefits of topical antibiotics stem not only from their antimicrobial effects, but also from the moist environment provided by antibacterial ointments (7)(8)(9). Although one of the primary causes of postsurgical wound infections is suboptimal skin antisepsis both preoperatively and postoperatively (10)(11)(12), the actual benefits of prophylactic topical antibiotics in minimizing wound infections are not strikingly evident (13)(14)(15)(16)(17)(18). The purpose of our systematic review and meta-analysis is to critically analyze the efficacy of topical antibiotics in preventing postsurgical wound infections in the dermatologic outpatient setting and then make clinical practice recommendations based on our findings.…”

Surgical antimicrobial prophylaxis

“…8 Despite insufficient evidence, antibiotic ointments and creams are frequently used for topical prophylaxis. 23 Antimicrobial prophylaxis should not be used as a stopgap for inadequate infection prevention measures. Similarly, topical prophylaxis should not be a substitute for good surgical closure technique and dressing management, particularly in cases where wounds are hard to seal and dress.…”