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Prophylactic and Empiric Use of Antibiotics in Dermatologic Surgery: A Review of the Literature and Practical Considerations


  • The authors have indicated no significant interest with commercial supporters.

Address correspondence and reprint requests to: Kavita Mariwalla, MD, Director of Mohs and Dermatologic Surgery, St. Luke's-Roosevelt, 1090 Amsterdam Avenue, Suite 11D, New York, NY 10025, or e-mail:



Although the risk of postoperative infection and bacteremia from dermatologic procedures remains low, many dermatologic surgeons continue to prescribe antibiotics, pre- and postoperatively. This practice can lead to unwanted morbidity and mortality and significantly increases associated healthcare costs and, even more ominously, increases bacterial resistance in the community.


To provide a comprehensive overview of antibiotic usage in dermatologic surgery and use evidence-based medicine to provide recommendations for antibiotic usage tailored to microbial pathogens.

Materials and Methods

A literature review was conducted to provide the most current overview of the guidelines for antibiotic use against surgical site infections, infective endocarditis, and hematogenous joint infection. In addition, recommendations for antibiotic use with implantable materials, such as fillers, and for special populations, such as organ transplant recipients, are provided.

Results and Conclusion

We focused on the most common bacterial pathogens related to surgical sites and effective antibiotics for each. In doing so, we seek to limit the unwarranted use of antibiotics in dermatologic surgery.