Antibiotic Use and Surgical Site Infections in Immunocompromised Patients After Mohs Micrographic Surgery: A Single-Center Retrospective Study.

Abstract

BACKGROUND:

As Mohs micrographic surgery becomes more widely used in immunosuppressed patients, it is important to understand the risks in this unique population.

OBJECTIVE:

To determine whether immunosuppressed patients are at an increased risk for surgical site infection and evaluate the utility of postoperative antibiotics for the prevention of surgical site infection.

MATERIALS AND METHODS:

A single-center retrospective review of patients who underwent Mohs micrographic surgery between October 9, 2014, and August 20, 2021, was performed.

RESULTS:

Five thousand eight hundred eighty-six independent cases were identified. Factors associated with an increased incidence of antibiotic use included preoperative lesion size >40 mm (86.7%, n = 13; p < .01) and high-risk lesion location (46.4%, n = 1,268; p < .01). Patients were not more likely to be prescribed antibiotics if immunosuppressed (37.0%, n = 269 vs 34.2%, n = 1765; p = .14), and immunosuppression was not independently associated with antibiotic use on multivariate analysis (odds ratio 1.2, 95% confidence interval 1.0-1.5). Infection rates were similar between immunocompromised patients and immunocompetent patients (2.1%, n = 15 vs 1.6%, n = 80, respectively; p = .30). In immunosuppressed patients, antibiotic use did not decrease the likelihood of infection (3.0%, n = 8 vs 1.5%, n = 7; p = .19).

CONCLUSION:

There was no association between immunosuppression and surgical infection rate. Furthermore, postoperative antibiotics should not be indicated in these patients unless other high-risk criteria exist.

• Authors: Tuyet A Nguyen, Georgina Rowe, Kristin Harris, Steven Ko, Matthew Ko, Nima M Gharavi
• Journal: Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.] (Dermatol Surg) Vol. 48 Issue 12 Pg. 1283-1288 (12 01 2022) ISSN: 1524-4725 [Electronic] United States
• PMID: 36449868 (Publication Type: Journal Article)
• Copyright: Copyright © 2022 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.

Chemical References

• Anti-Bacterial Agents

Topics

• Humans
• Surgical Wound Infection (epidemiology, etiology, prevention & control)
• Mohs Surgery (adverse effects)
• Retrospective Studies
• Anti-Bacterial Agents (therapeutic use)
• Immunocompromised Host