An international survey of oculoplastic surgeons found a wide range of practice patterns for the use of antibiotics during routine eyelid surgery—and revealed that they may overestimate the benefits of antibiotics.
Edward J. Wladis, MD, FACS, associate professor of ophthalmic plastic surgery, Lions Eye Institute, Albany Medical College, Albany, NY, shared the survey results, which have been published in JAMA Ophthalmology.1
The survey was sent to surgeons who belong to oculoplastic societies around the world, including Australia, New Zealand, the Asia-Pacific, the United States, the United Kingdom, Brazil, Europe, India, France, and Spain. Survey questions asked about demographics, length of training, and prescribing patterns.
The survey specifically inquired about the use of oral antibiotics after a procedure, intravenous (IV) antibiotics, and topical antibiotics after surgery for up to 1 week. Respondents also were asked to estimate their risk for gastrointestinal effects for a week-long course of antibiotics, as well as the risk of infection without the use of antibiotics.
Dr. Wladis and colleagues sent the survey to 2,397 surgeons and received 782 responses from surgeons in 43 countries. One trend among all countries and surgeons was the use of topical antibiotics.
“Eighty-five percent prescribed them for home use in the first week,” Dr. Wladis said. “Eighty-eight percent used them for immediately after surgery.”
In contrast, the use of fourth-generation antibiotics before routine eyelid surgery was much less common. They were used by only 14% of surgeons before routine oculoplastic procedures, but there were outliers on both ends of the spectrum.
For example, 37% of surgeons in Italy and 27% in Argentina and Italy used fourth-generation antibiotics. On the other end, only 3% of surgeons in the U.K. and 3% in India used them.