Cutaneous CO2 laser resurfacing infection rate with and without prophylactic antibiotics.

BACKGROUND: Cutaneous laser resurfacing is a well-accepted modality, with excellent clinical outcomes and low morbidity rates, for the treatment of a variety of epidermal and dermal lesions. The use of antibiotic prophylaxis continues to be an area of controversy, with laser practitioners divided in their approach.

OBJECTIVE: To identify the rate of postoperative bacterial infection following full-face carbon dioxide (CO2) laser resurfacing with and without antibiotic prophylaxis.

METHODS: A retrospective chart review of 133 consecutive patients following full-face CO2 laser resurfacing was performed. The rate, severity, duration, and subsequent treatment of bacterial infections observed in four treatment categories were recorded: (1) no antibiotic prophylaxis; (2) intraoperative single-dose intravenous cephalexin (1 g); (3) postoperative oral azithromycin (1.5 g over 5 days); (4) intraoperative IV cephalexin (1 g) and postoperative oral azithromycin (1.5 g).

RESULTS: A significantly higher rate of infection occurred in patients receiving combination intraoperative and/or postoperative antibiotic prophylaxis. The most frequently cultured organisms included Enterobacter and Pseudomonas species.

CONCLUSION: The rate of postoperative bacterial infections after full-face CO2 laser resurfacing in this retrospective study was not significantly reduced with the use of prophylactic antibiotics.