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

Autor:	Nguyen TA; Department of Dermatology, Cedars-Sinai Medical Center, Beverly Hills, California.; Department of Dermatology, Kaiser Permanente, Los Angeles, California., Rowe G; Department of Dermatology, Cedars-Sinai Medical Center, Beverly Hills, California.; Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California., Harris K; Department of Dermatology, Cedars-Sinai Medical Center, Beverly Hills, California., Ko S; Department of Dermatology, Cedars-Sinai Medical Center, Beverly Hills, California., Ko M; Department of Dermatology, Cedars-Sinai Medical Center, Beverly Hills, California., Gharavi NM; Department of Dermatology, Cedars-Sinai Medical Center, Beverly Hills, California.
Jazyk:	angličtina
Zdroj:	Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.] [Dermatol Surg] 2022 Dec 01; Vol. 48 (12), pp. 1283-1288. Date of Electronic Publication: 2022 Nov 03.
DOI:	10.1097/DSS.0000000000003620
Abstrakt:	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. (Copyright © 2022 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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