Antibiotic prophylaxis for dermatologic surgery in adults

Situation	Potential organisms encountered	Agent	Regimen: single oral dose 30 to 60 minutes before procedure
Prevention of surgical site infection
Surgery involving glabrous skin, nonoral	Staphylococcus aureus Streptococcus pyogenes Staphylococcus epidermidis	Cephalexin	2 g
		OR
		Clindamycin	600 mg
		OR
		Azithromycin or clarithromycin	500 mg
Surgery involving ear, groin, or lower extremities (below the knee)	S. aureus S. pyogenes S. epidermidis Pseudomonas aeruginosa Escherichia coli Enterococcus	Cephalexin	2 g
		OR
		Trimethoprim-sulfamethoxazole	160 mg trimethoprim/800 mg sulfamethoxazole
		OR
		Ciprofloxacin	500 mg
Any site, increased risk of MRSA infection		Clindamycin	600 mg
		OR
		Trimethoprim-sulfamethoxazole	160 mg trimethoprim/800 mg sulfamethoxazole
Prevention of infective endocarditis or hematogenous total joint infection in patients at high risk
Surgery involving the oral mucosa	S. aureus S. pyogenes Streptococcus viridans	Amoxicillin	2 g
		OR
		Cephalexin	2 g
		OR
		Clindamycin	600 mg
		OR
		Azithromycin or clarithromycin	500 mg
Surgery involving infected skin (eg, incision and drainage of skin abscess)	S. aureus S. pyogenes	Cephalexin	2 g
		OR
		Clindamycin	600 mg
		OR
		Azithromycin or clarithromycin	500 mg
Any site, increased risk of MRSA infection		Clindamycin	600 mg
		OR
		Trimethoprim-sulfamethoxazole	160 mg trimethoprim/800 mg sulfamethoxazole

MRSA: methicillin-resistant Staphylococcus aureus.

Graphic 69096 Version 3.0