Antibiotic Prophylaxis and Dermatologic Surgery-Reply

Abstract

In Reply.— Although Dr Lycka does not question the use of antibiotic prophylaxis for procedures such as oral, gastrointestinal, or genitourinary surgery, he avoids the fact that there have never been controlled clinical trials that prove that antibiotic prophylaxis will decrease the risk for bacterial endocarditis associated with these procedures. In fact, it is not likely that such a study will ever be conducted. 1 Thus, the decision to administer antibiotic prophylaxis against possible bacterial endocarditis is a medical judgment that rests on the specific risk-to-benefit ratio. It is our opinion that patients at high risk for bacterial endocarditis who undergo dermatologic surgery should receive appropriate antibiotic prophylaxis. 2 Fine et al 3 have recently reported significant bacteremia following the incision and drainage of abscesses and have advised for appropriate bacterial endocarditis prophylaxis. Kaye 4 has also recommended antibiotic prophylaxis against bacterial endocarditis for the surgical management of abscesses in