Choosing Wisely:

Don’t routinely use topical antibiotics on a surgical wound.

Rationale and Comments: The use of topical antibiotics on clean surgical wounds has not been shown to reduce the rate of infection compared to the use of non-antibiotic ointment or no ointment. Topical antibiotics can aggravate open wounds, hindering the normal wound-healing process. When topical antibiotics are used in this setting, there is a significant risk of developing contact dermatitis, a condition in which the skin becomes red, sore, or inflamed after direct contact with a substance, along with the potential for developing antibiotic resistance. Only wounds that show symptoms of infection should receive appropriate antibiotic treatment.
Sponsoring Organizations:
  • American Academy of Dermatology
  • Sources:
  • Randomized controlled trials
  • Disciplines:
  • Surgical
  • Infectious disease
  • References: • Dixon AJ, Dixon MP, Dixon JB. Randomized clinical trial of the effect of applying ointment to surgical wounds before occlusive dressing. Br J Surg. 2006 Aug;93(8):937-43.
    • Smack DP, Harrington AC, Dunn C, Howard RS, Szkutnik AJ, Krivda SJ, Caldwell JB, James WD. Infection and allergy incidence in ambulatory surgery patients using white petrolatum vs bacitracin ointment. A randomized controlled trial. JAMA. 1996 Sep 25;276(12):972-7.
    • Campbell RM, Perlis CS, Fisher E, Gloster HM Jr. Gentamicin ointment versus petrolatum for management of auricular wounds. Dermatol Surg. 2005 Jun;31(6):664-9.
    • Sheth VM, Weitzul S. Postoperative topical antimicrobial use. Dermatitis. 2008 Jul-Aug;19(4):181-9.
    • Gehrig KA, Warshaw EM. Allergic contact dermatitis to topical antibiotics: epidemiology, responsible allergens, and management. J Am Acad Dermatol. 2008 Jan;58(1):1-21.

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