In a single-institution study conducted in New Zealand reported in JAMA Surgery, Goh et al found that microdoses of incisional antibiotics may reduce the risk of surgical site infections during surgery for skin cancer, as well as reduce the risk of infections requiring postoperative systemic antibiotics. Researchers compared the efficacy of flucloxacillin or clindamycin vs buffered local anesthetic alone in cutaneous surgery. A postoperative wound infection score of ≥ 5 was observed in 22 (5.7%) of 388 lesions from patients in the control group, 17 (5.3%) of 323 in the flucloxacillin group, and 9 (2.1%) of 422 in the clindamycin group. Postoperative systemic antibiotics were required for 31 (8.0%) of 388 lesions from patients in the control group, 13 (4.0%) of 323 in the flucloxacillin group, and 9 (2.1%) of 422 in the clindamycin group. The study authors concluded, “In a double-blinded, prospective randomized clinical trial, microdosed clindamycin delivered simultaneously with local anesthetic significantly reduced both the rate of surgical site infection overall and the prescription of systemic antibiotics during postoperative follow-up. The intervention is safe, easily implemented in routine practice, and substantially reduces unintended antimicrobial selection outside the targeted operative field.”
June 08, 2023