Preferences for Prophylactic Oral Antibiotic Use in Dermatologic Surgery: A Multicenter Discrete Choice Experiment

Leora Aizman, John S. Barbieri, Elea M. Feit, Tess M. Lukowiak, Allison M. Perz, Thuzar M. Shin, Christopher J. Miller, Nicholas Golda, Justin J. Leitenberger, David R. Carr, Rajiv I. Nijhawan, Aliza Hasan, Daniel B. Eisen, Jeremy R. Etzkorn

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

BACKGROUND: Antibiotics are often prescribed after dermatologic surgery for infection prophylaxis, but patient preferences about prophylactic antibiotics are not well understood. OBJECTIVE: To understand patient preferences about taking antibiotics to prevent surgical site infection (SSI) relative to antibiotic efficacy and antibiotic-associated adverse drug reactions. MATERIALS AND METHODS: Multi-center, prospective discrete choice experiment (DCE). RESULTS: Three hundred thirty-eight respondents completed the survey and DCE. 54.8% of respondents preferred to take an antibiotic if it reduced the SSI rate from 5% to 2.5% and if the risk of adverse drug reactions was low (1% risk gastrointestinal upset, 0.5% risk itchy skin rash, 0.01% risk emergency department visit). Even if an antibiotic could eliminate SSI risk (0% risk SSI) and had a low adverse drug reaction profile, 26.7% of respondents prefer not to take prophylactic oral antibiotics. CONCLUSION: Risk-benefit thresholds for taking antibiotics to prevent SSI vary widely. Clinical trials are needed to better characterize the effectiveness and risks of oral antibiotic SSI prophylaxis to guide decision-making. Future studies should also evaluate whether shared decision-making can improve the patient experience.

Original languageEnglish (US)
Pages (from-to)1214-1219
Number of pages6
JournalDermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.]
Volume47
Issue number9
DOIs
StatePublished - Sep 1 2021

ASJC Scopus subject areas

  • Surgery
  • Dermatology

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