Incidence of Bacteremia, Infective Endocarditis, or Prosthetic Joint Infection in Dermatologic Surgery: A Systematic Review

Dermatol Surg. 2024 May 1;50(5):428-433. doi: 10.1097/DSS.0000000000004101. Epub 2024 Feb 6.

Abstract

Background: Prophylactic antibiotic therapy is widely used in dermatologic surgery to prevent surgical site infections and bacteremia, which can lead to prosthetic joint infections (PJI) and infective endocarditis (IE) in high-risk populations.

Objective: To evaluate the incidence of bacteremia, PJI, and IE after dermatologic surgery and assess the current evidence for antibiotic prophylaxis.

Materials and methods: A search of the computerized bibliographic databases was performed using key terms from the date of inception to March 21, 2021. Data extraction was performed independently by 2 data extractors.

Results: The review resulted in 9 publications that met inclusion criteria, including 5 prospective cohort studies and 4 case reports or case series. The prospective studies reported a wide range of bacteremia incidence (0%-7%) after dermatologic surgery. No cases of PJI resulting directly from cutaneous surgery were identified, and only 1 case series reported IE after various skin procedures.

Conclusion: These findings suggest a low rate of bacteremia and a lack of direct evidence linking dermatologic surgery to PJI or IE. The scarcity of published data on this topic is a limitation, highlighting the need for further research, particularly randomized controlled trials, to guide antibiotic prophylaxis recommendations.

Publication types

  • Systematic Review

MeSH terms

  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / therapeutic use
  • Antibiotic Prophylaxis*
  • Bacteremia* / epidemiology
  • Bacteremia* / etiology
  • Bacteremia* / prevention & control
  • Dermatologic Surgical Procedures* / adverse effects
  • Endocarditis / epidemiology
  • Endocarditis / etiology
  • Endocarditis, Bacterial / epidemiology
  • Endocarditis, Bacterial / etiology
  • Humans
  • Incidence
  • Prosthesis-Related Infections* / epidemiology
  • Prosthesis-Related Infections* / etiology
  • Prosthesis-Related Infections* / prevention & control
  • Surgical Wound Infection / epidemiology
  • Surgical Wound Infection / etiology
  • Surgical Wound Infection / prevention & control

Substances

  • Anti-Bacterial Agents