Studies of systemic antibiotic prophylaxis for skin lesion excision
| Study, country | Setting and sample size | Intervention and control | Wound type | Infection rate (relative reduction) |
|---|---|---|---|---|
| Amland et al,28 Norway | Plastic surgery unit, 60 patients | Control: placebo Intervention: single dose 1000 mg orally azithromycin the night before surgery | Skin cancer surgery | Control: 16.0% Azithromycin: 5.7% (0.36) |
| Bencini et al,29 Italy | Outpatient dermatologic surgery unit, 527 patients | A: no prophylaxis B: 1 g intramuscular cefazolin 12 hourly for 48 h before and after surgery C: 1 g intramuscular cefazolin 12 hourly from 2 h before surgery to 24 h after D: single 1 g intramuscular dose cefazolin 2 h before surgery | Excisions from contamination- prone areas (groin, axillae, interdigital spaces of feet) | A: 12% B: 4.6% (0.38)* C: 0.77% (0.064)* D: 2% (0.17)* |
| Czarnecki et al,30 Australia | Outpatient dermatology clinic, 97 lesions | Intervention 1: 500 mg orally cephalexin three times a day, starting 2 days before and continuing 24 h postoperatively Intervention 2: topical mupirocin three times a day from 2 days before and continuing 24 h postoperatively Control: cetrimide-chlorhexidine cream 2 days before and continuing 24 h postoperatively | Ulcerated skin cancers which cultured positive for Staphylococcus aureus or Gram-negative bacteria | Control: 21.7% Intervention 1: 2.7% (0.12)* Intervention 2: 0% (0)* |
| Bencini et al,31 Italy | Outpatient dermatologic surgery unit, 2165 patients | A: no antibiotic B: 1 g intramuscular cefazolin 12 hourly immediately after surgery continuing for 3 days C: 250 mg cefazolin powder applied locally during surgery D: 1 g cefazolin intramuscular 12 hourly starting 2 days before and continuing 2 days after surgery | Excision of skin lesions | A: 4.3% B: 1.5% (0.35)* C: 0.9% (0.21)* D: 0.2% (0.047)* |
*Statistically significant reduction compared to control.