Antibiotic timing and risk stratification are critical in reducing postoperative infections following dermatologic surgery, according to new guidance from the German Society for Dermatosurgery.
Surgical site infections remain a potential complication of any dermatosurgical procedure, increasing patient morbidity and potentially leading to severe outcomes. In an effort to reduce these risks, recent recommendations emphasize targeted perioperative antibiotic use based on individualized risk factors and procedure characteristics.
Not all dermatologic surgeries warrant prophylactic antibiotics, but for select cases, especially those involving a high contamination risk or vulnerable patient populations, perioperative administration may provide a critical benefit. The decision to use antibiotics should be guided by factors including the type and site of the procedure, whether the surgical field is contaminated, and patient-specific concerns such as immunosuppression or comorbid conditions.
The latest recommendations stress that when indicated, antibiotic prophylaxis should be administered 30 to 60 minutes before the procedure begins. This timing optimizes drug efficacy during the surgical window. Administration routes include both oral and intravenous options, with the method chosen based on clinical context.
These findings align with broader principles of antibiotic stewardship, aiming to balance infection prevention with the minimization of unnecessary antibiotic exposure. By refining clinical decision-making through proper risk stratification, dermatologic surgeons can improve patient safety without contributing to antibiotic resistance.
This evolving guidance serves as a practical framework for healthcare professionals involved in cutaneous surgery, offering actionable steps to reduce postoperative complications while upholding responsible prescribing practices.
Reference:
Glatzel V et al. Antibiotics and dermatologic procedures. Review Dermatologie (Heidelb). 2025. doi: 10.1007/s00105-025-05532-x. [Online ahead of print]
