We appreciate the input of Dr Gross into a highly controversial issue. The role of prophylactic antibiotics prior to cutaneous surgery is not only poorly defined, but frequently challenged in this era of concern for development of antibiotic resistance.
Although Gross addresses comments from our letter to the editor of the ARCHIVES published in June 1999,1 a review of the original publication of our research from June 19982 may clear up some of his confusion. The reference cited in our 1998 publication reported the use of prophylactic antibiotics in 77% of patients following Mohs surgery.3 Our experience with consultants who repair defects after Mohs surgery reflects a similar frequency in the use of prophylactic antibiotics. This is quite different than the informal survey conducted by Gross.
Griego RD, Zitelli JA. Use Caution When Establishing "Routine" Prophylactic Antibiotic Procedures—Reply. Arch Dermatol. 2000;136(2):267-268. doi: