title: 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.
abstract: 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.
authors.affiliation: Department of Dermatology, Naval Medical Center San Diego, CA 92134-5000, USA.
authors.forename: E V
authors.initials: EV
authors.lastname: Ross
authors.forename: E C
authors.initials: EC
authors.lastname: Amesbury
authors.forename: A
authors.initials: A
authors.lastname: Barile
authors.forename: L
authors.initials: L
authors.lastname: Proctor-Shipman
authors.forename: B D
authors.initials: BD
authors.lastname: Feldman
mesh_terms: 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*