title: Effect of prophylactic antibiotics on polyacrylamide gel safety in facial augmentation.
abstract: BACKGROUND
  Polyacrylamide hydrogel has in the last decade gained popularity as an injectable filler for facial augmentation due to its features of non-toxicity, biocompatibility, safety profile, and immediate effect. However, as all types of injections carry the risk of infection and since the polyacrylamide hydrogel is a non-degradable implant, the possibility of bacterial biofilm formation exists. Theoretically, the risk of infection and subsequent biofilm formation can be avoided by using prophylactic antibiotic treatment prior to the time of injection.
  
  
  METHODS
  This retrospective study of outcomes following polyacrylamide hydrogel injections includes 657 subjects from one centre, which had facial injections from 2001 and 2011. Until 2007 prophylactic antibiotics were not given prior to treatment, but in September 2007 a single oral dose of azithromycin (Zitromax) and moxifloxacin (Avelox) was introduced as prophylactic antibiotics. A total of 496 subjects were injected before 2007 without antibiotic prophylactic treatment, and 161 subjects received these two antibiotics prior to treatment from September 2007.
  
  
  RESULTS
  The prophylactic antibiotics (azithromycin and moxifloxacin) significantly reduced the incidence of clinical signs of inflammation/infections from 7 to 2% (P=0.03).
  
  
  CONCLUSIONS
  Even though the incidence of inflammation/infections following injection of polyacrylamide hydrogel is relatively low, it may be reduced further by using prophylactic antibiotic treatment. Based on our experience, we recommend prophylactic antibiotics to patients who have facial augmentation with polyacrylamide hydrogel in order to avoid infection and risk of biofilm formation due to contamination during injection with naturally occurring micro flora from skin and lips.
authors.forename: Jesper F
authors.initials: JF
authors.lastname: Nygart
authors.forename: Victoria A
authors.initials: VA
authors.lastname: Nygart
authors.forename: Marie
authors.initials: M
authors.lastname: Borggren
authors.forename: Michael
authors.initials: M
authors.lastname: Tvede
mesh_terms: D000180:Acrylic Resins / Q000008:administration & dosage* / Q000009:adverse effects; D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D019072:Antibiotic Prophylaxis / Q000379:methods; D017963:Azithromycin / Q000008:administration & dosage / Q000627:therapeutic use; D001424:Bacterial Infections / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D018441:Biofilms / Q000187:drug effects; D003357:Cosmetic Techniques / Q000009:adverse effects; D005145:Face; D005260:Female; D024841:Fluoroquinolones / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D015994:Incidence; D007249:Inflammation / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D007267:Injections; D008297:Male; D008875:Middle Aged; D000077266:Moxifloxacin; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D000180:Acrylic Resins; D000900:Anti-Bacterial Agents; D024841:Fluoroquinolones; C016680:polyacrylamide gels; D017963:Azithromycin; D000077266:Moxifloxacin