HealthDay News — Postoperative antibiotic prescriptions are associated with reduced rates of infections after facial plastic surgery, according to a study published online Oct. 24 in JAMA Facial Plastic Surgery.
Cristen Olds, MD, from Stanford Hospital and Clinics in California, and colleagues used IBM MarketScan Commercial and Medicare Supplemental research databases to identify 294,039 patients (55.9% women; mean age, 54 years) who underwent facial plastic surgery procedures during 2007 to 2015. Antibiotic prescription patterns in the immediate postoperative period were assessed along with rates of postoperative infectious complications.
The researchers found that 45.2% of patients filled prescriptions for postoperative antibiotics, including 55.3% undergoing nasal procedures and 14.7% undergoing oculoplastic procedures. Superficial and deep surgical site infections occurred in 1.6% and 0.3% of patients, respectively. Patients receiving postoperative antibiotics were at significantly decreased risk for postoperative infections for both nasal and oculoplastic procedures (adjusted odds ratios [aORs], 0.144 [95% confidence interval (CI), 0.102 to 0.203] and 0.254 [95% CI, 0.104 to 0.622], respectively) versus patients who did not receive postoperative antibiotics. There was no association noted between longer duration of postoperative antibiotics and reduced rates of infectious complications (nasal procedures: aOR, 1.000; 95% CI, 0.978 to 1.022; oculoplastic procedures: aOR, 1.024; 95% CI, 0.959 to 1.092). Despite a higher risk for postoperative infections, patients with a history of tobacco use (aOR, 0.806; 95% CI, 0.747 to 0.870), immunodeficiency (aOR, 0.774; 95% CI, 0.737 to 0.813), or type 1 or 2 diabetes (aOR, 0.810; 95% CI, 0.772 to 0.850) were less likely to be prescribed antibiotics than those without these conditions.
“This study highlights the role of population-level data in the development of best practices for postoperative antibiotic use and identifies the need for additional examination of antibiotic use patterns and recommendations for populations at increased risk for postoperative wound infection,” the authors write.