Until randomized controlled trials examining the efficacy of prophylactic antibiotics in aesthetic surgery are performed, we recommend giving prophylactic antibiotics in accordance with SIP project guidelines.The ideal antibiotic for surgical prophylaxis should (1) cause minimal toxicity or side effects, (2) be effective against the most likely organisms that will cause an SSI but have a narrow spectrum, (3) achieve adequate tissue concentrations at the surgical site for the duration of the procedure, and (4) be administered for the shortest effective period.
- Nasal decolonization with mupirocin twice daily for 5–10 days.
- Nasal decolonization with mupirocin twice daily for 5–10 days and topical body decolonization regimens with a skin antiseptic solution (eg, chlorhexidine) for 5–14 days or dilute bleach baths. (For dilute bleach baths, 1 teaspoon per gallon of water [or ¼ cup per ¼ tub or 13 gallons of water] given for 15 min twice weekly for 3 months can be considered.)
The SIP project guidelines recommend against continuing antibiotic prophylaxis for the duration of surgical drain placement for orthopedic and cardiothoracic procedures. It should be noted that antibiotic therapy is appropriate when the surgical drain is placed for therapeutic drainage of an infected space or abscess.