After routine oculofacial plastic surgery, patients who are treated with topical antibiotic ointment may be at a lower risk of surgical site infection compared with individuals who use a non-antibiotic ointment, a study in Ophthalmology reports.

In light of concerns for contact dermatitis, antibiotic resistance and rising healthcare costs, a research team analyzed the frequency of infection with and without the use of topical antibiotic prophylaxis. There is already a low baseline rate of surgical site infections, they note.

A total of 401 participants were randomized preoperatively to receive either antibiotic or a placebo—mineral oil/petrolatum-based—ointment after surgery. The primary outcome was the incidence of surgical site infections. The secondary outcomes included stratification of infections by patient risk characteristics, incidence of allergic contact dermatitis, and incidence of wound complications. Thirteen participants did not proceed with surgery or were lost to follow-up.

The study found high-risk features for infection in 24% of the placebo group and 21% of the antibiotic group. Additionally, surgical site infections were more common in the placebo group at 2.7% vs. zero in the antibiotic group.

The rate of contact dermatitis was similar in both groups (0.5%), as well as the rate of wound dehiscence, 2.7% vs. 3.6%, respectively.

For individuals who were treated with the placebo, the incidence of infections in the low- and high-risk participants was 2.9% and 2.2%, respectively. Infections were treated with oral or topical antibiotics and resolved without complication, except in one case that required two subsequent surgeries.

Ashraf DC, Idowu OO, Wang Q, et al. The role of topical antibiotic prophylaxis in oculofacial plastic surgery: a randomized controlled study. Ophthalmology. July 19, 2020. [Epub ahead of print].