Antibiotic prophylaxis guideline awareness and antibiotic prophylaxis use among New York State dermatologic surgeons.
BACKGROUND
Use of antibiotic prophylaxis in dermatologic surgery patients remains controversial and several sets of guidelines exist.


OBJECTIVE
We investigated dermatologic surgeon's awareness of the American Heart Association (AHA) 1997 antibiotic prophylaxis guidelines, their use of prophylactic antibiotics, and their practices as compared with the Haas and Grekin's 1995 antibiotic prophylaxis guidelines.


METHODS
We mailed postage-paid questionnaires regarding AHA guideline awareness and antibiotic prophylaxis use to the 235 New York State members of the American Society for Dermatologic Surgery (ASDS). We received 87 replies.


RESULTS
Most participants recognize AHA guidelines and claim to follow them. We reiterate previous studies' findings. Most dermatologic surgeons use antibiotics appropriately. However, antibiotics are occasionally overused or dosed outside the guidelines. Many participants prescribe antibiotics based on a patient's other physicians' recommendations. Notably, erythromycin is sometimes used, an antibiotic the AHA no longer recommends.


CONCLUSIONS
Dermatologic surgeons commonly use antibiotic prophylaxis to prevent bacterial endocarditis. Based on previous studies, though, the risk of endocarditis following cutaneous surgery is low and thus the use of antibiotic prophylaxis is controversial. Although this practice is appropriate for high-risk patients when skin is contaminated, it is not recommended for noneroded, noninfected skin. We report that dermatologists may be aware of the guidelines, but only seem to partially follow them. Further studies are still needed to establish optimal guidelines.
Scheinfeld
Noah
N
Department of Dermatology, Beth Israel Medical Center and St. Luke's-Roosevelt Hospital Center, New York, New York, USA.
Struach
Shari
S
Ross
Bonnie
B
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D019072:Antibiotic Prophylaxis / Q000706:statistics & numerical data*; D002511:Cephalosporins / Q000627:therapeutic use; D003880:Dermatology / Q000592:standards* / Q000706:statistics & numerical data; D019983:Guideline Adherence; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D009518:New York; D017410:Practice Guidelines as Topic
D000900:Anti-Bacterial Agents; D002511:Cephalosporins