Incidence of postoperative infection or positive culture after facial laser resurfacing: a pilot study, a case report, and a proposal for a rational approach to antibiotic prophylaxis.
BACKGROUND
Laser skin resurfacing (LSR) has emerged as a popular procedure for facial rejuvenation; however, there are no clear guidelines regarding systemic antibiotic prophylaxis.


OBJECTIVE
We attempt to provide practical guidelines for antibiotic prophylaxis in LSR based on our experiences, pharmacology, and a review of the literature.


METHODS
In a pilot study, four consecutive full-face LSR patients were treated without oral or topical antibiotics. The next four patients received oral prophylaxis with a narrow spectrum antibiotic. We also report the case of a severe gram-negative infection after LSR.


RESULTS
For full-face LSR, 2 of 4 consecutive patients without antibiotic prophylaxis experienced focal Staphylococcus aureus infection. The next 4 consecutive patients, who had received gram-positive oral prophylaxis, were all culture negative after 2 days. All test sites (5 of 5) were culture negative despite the absence of systemic or topical antibiotics. One patient not in the pilot study receiving gram-positive antibiotic prophylaxis experienced a gram-negative infection.


CONCLUSIONS
We recommend narrow-spectrum gram-positive oral antibiotic coverage for full-face and regional LSR.
Ross
E V
EV
Department of Dermatology, Naval Medical Center San Diego, CA 92134-5000, USA.
Amesbury
E C
EC
Barile
A
A
Proctor-Shipman
L
L
Feldman
B D
BD
D000368:Aged; D019072:Antibiotic Prophylaxis; D005260:Female; D006801:Humans; D015994:Incidence; D053685:Laser Therapy / Q000009:adverse effects*; D010865:Pilot Projects; D017410:Practice Guidelines as Topic; D015361:Rhytidoplasty / Q000009:adverse effects*; D013203:Staphylococcal Infections / Q000209:etiology / Q000517:prevention & control*; D013211:Staphylococcus aureus / Q000302:isolation & purification*; D013530:Surgical Wound Infection / Q000209:etiology / Q000517:prevention & control*