Dermatologic procedures: antibiotic prescribing is on the rise

  • Barbieri JS & al.
  • JAMA Dermatol
  • 02/03/2019

  • Brian Richardson, PhD
  • Clinical Essentials
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Takeaway

  • Analysis of the Optum Clinformatics DataMart database suggests that antibiotic prescribing increased between 2008 and 2016 for dermatologic procedures.

Why this matters

  • High antibiotic use may increase rates of adverse events and promote antibiotic resistance.

Key results

  • Antibiotic prescribing for benign excisions increased from 2.9% to 4.4% (incidence rate ratio [IRR], 1.04; 95% CI, 1.03-1.04).
  • Antibiotic prescribing for malignant excisions increased from 4.2% to 6.3% (IRR, 1.06; 95% CI, 1.05-1.06).
  • Antibiotic prescribing for Mohs surgery increased from 9.9% to 13.8% (IRR, 1.04; 95% CI, 1.03-1.04).
  • Antibiotic prescription rates were 3.6% in the lowest utilizing division (West North Central) vs 9.9% in the highest utilizing division (West South Central) for malignant excisions and 7.6% in the lowest utilizing division (West North Central) vs 16.9% in the highest utilizing division (West South Central) for Mohs surgery.
  • If the highest utilizing regions prescribed antibiotics at a rate similar to the lowest-utilizing region, 57.6%, 53.6%, and 55.8% reductions in antibiotic use associated with benign excisions, malignant excisions, and Mohs surgery, respectively, would be achieved.

Study design

  • 1,128,244 patients undergoing dermatologic procedures (1,934,633 total encounters) were included.
  • Funding: National Institute of Arthritis and Musculoskeletal and Skin Diseases.

Limitations

  • Retrospective analysis of large database.