To the Editor.—
I would like to acknowledge the recent article by Wagner et al entitled "Antibiotic Prophylaxis Against Bacterial Endocarditis in Patients Undergoing Dermatologic Surgery" (Arch Dermatol 1986;122:799-801). Their recommendations on the use of prophylactic antibiotics are truly simple to use, and hence conducive to patient and physician compliance. However, the issue that the authors fail to adequately address is whether prophylaxis for dermatologic surgery is indeed necessary.Antimicrobial prophylaxis in any surgery is deemed necessary in situations where there is a high risk for postoperative infection and the postoperative infection is potentially severe.1 In terms of bacterial endocarditis, this risk has been traditionally limited to situations in which there is an underlying cardiac lesion and surgical trauma to mucosal surfaces (ie, oral, gastrointestinal, or genitourinary) that are likely to produce bacteremia. Antimicrobial prophylaxis has been omitted in other cases, including dermatologic surgery, as the patients have been
Lycka B. Antibiotic Prophylaxis and Dermatologic Surgery. Arch Dermatol. 1987;123(4):424–425. doi:10.1001/archderm.1987.01660280024005
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