Topical Antibiotic Trends from 1993 to 2007: Use of Topical Antibiotics for Non-Evidence-Based Indications
Article first published online: 2 SEP 2011
© 2011 by the American Society for Dermatologic Surgery, Inc.
Volume 37, Issue 10, pages 1427–1433, October 2011
How to Cite
Lapolla, W. J., Levender, M. M., Davis, S. A., Yentzer, B. A., Williford, P. M. and Feldman, S. R. (2011), Topical Antibiotic Trends from 1993 to 2007: Use of Topical Antibiotics for Non-Evidence-Based Indications. Dermatologic Surgery, 37: 1427–1433. doi: 10.1111/j.1524-4725.2011.02122.x
- Issue published online: 6 OCT 2011
- Article first published online: 2 SEP 2011
BACKGROUND Systemic antibiotic use has become more conservative with the emergence of drug resistance. Topical antibiotics are employed for a variety of indications, although there are only a few evidence-based indications.
OBJECTIVE To examine topical antibiotics use in the outpatient setting.
METHODS Topical antibiotic use was characterized using data from the 1993 to 2007 National Ambulatory Medical Care Survey. Visits were identified at which a topical antibiotic was used and analyzed according to patient demographics, diagnoses, procedures, concomitant medications, and provider specialty. Topical antibiotic use over time was analyzed using linear regression.
RESULTS The most frequent diagnoses associated with topical antibiotic use were benign or malignant neoplasm of skin, impetigo, insect bite, and cellulitis. Data revealed a significant downward trend in topical antibiotics associated with dermatologic surgery (p<.001) and a nonsignificant downward trend in use in conjunction with skin biopsies (p=.09). Topical antibiotic use by dermatologists was noted to be decreasing over time, whereas among non dermatologists, it was noted to be increasing, although neither of these trends was statistically significant.
CONCLUSION Topical antibiotics continue to be used for non-evidence-based indications, despite data that suggest that such use may be detrimental for patients and represents significant costs to the health care system.
The authors have indicated no significant interest with commercial supporters.