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Background: Surgical site infection (SSI) after minor surgery in primary care can compromise cosmetic outcomes, delay wound healing and increase costs. In addition to efficacy, adverse effects must be considered when considering antibiotic prophylaxis. There is no prior published literature regarding the proportion of general practitioners (GPs) who use topical antibiotics as SSI prophylaxis following minor surgery. Objectives: To identify the proportion of GPs in a regional center in Queensland, Australia who apply topical antibiotics to wounds prevent SSIs after minor surgery. Method: A database of 90 GPs was established, and they were invited to complete a questionnaire. Results: The response rate was 62% (56/90). Topical antibiotics prophylaxis was reported as being used always or sometimes in routine practice by 18% (10/56) of participants after both skin lesion excision and repair of lacerations. In the context of high-risk situations, on the other hand, use was higher. They were more likely to be used in high-risk situations, most frequently in diabetic patients(41.0% [23/56]) and immunocompromised patients (46.5% [26/56]). Conclusions: Evidence-based prescribing of antibiotics is vital. Topical antibiotic prophylaxis is often prescribed excessively after clean dermatological surgery, however, in our sample of GPs, only 18%used topical antibiotics always or sometimes in their practice.

Background Surgical-site infections (SSIs) increase patient morbidity and costs. The aim was to identify and synthesize all RCTs evaluating the effect of topical antibiotics on SSI in wounds healing by primary intention. Methods The search included Ovid MEDLINE, Ovid Embase, the Cochrane Wounds Specialized Register, Central Register of Controlled Trials and EBSCO CINAHL from inception to May 2016. There was no restriction of language, date or setting. Two authors independently selected studies, extracted data and assessed risk of bias. When sufficient numbers of comparable trials were available, data were pooled in meta-analysis. Results Fourteen RCTs with 6466 participants met the inclusion criteria. Pooling of eight trials (5427 participants) showed that topical antibiotics probably reduced the risk of SSI compared with no topical antibiotic (risk ratio (RR) 0·61, 95 per cent c.i. 0·42 to 0·87; moderate-quality evidence), equating to 20 fewer SSIs per 1000 patients treated. Pooling of three trials (3012 participants) for risk of allergic contact dermatitis found no clear difference between antibiotics and no antibiotic (RR 3·94, 0·46 to 34·00; very low-quality evidence). Pooling of five trials (1299 participants) indicated that topical antibiotics probably reduce the risk of SSI compared with topical antiseptics (RR 0·49, 0·30 to 0·80; moderate-quality evidence); 43 fewer SSIs per 1000 patients treated. Pooling of two trials (541 participants) showed no clear difference in the risk of allergic contact dermatitis with antibiotics or antiseptic agents (RR 0·97, 0·52 to 1·82; very low-quality evidence). Conclusion Topical antibiotics probably prevent SSI compared with no topical antibiotic or antiseptic. No conclusion can be drawn regarding whether they cause allergic contact dermatitis.