Antibiotic use answered

Thank you Dr Cooper for your letter and comments. We are aware that the current international trend regarding prophylactic use of antibiotics in surgery is to discontinue perioperative antibiotics within 24 hours after the end of surgery or not to give any at all in the majority of surgical procedures. However, in our cases we regarded the wounds as contaminated because most eyelid neoplasms showed evidence of infection and necrotic tissue. Furthermore, we performed reconstructive surgery using a large skin sliding graft that usually exposes the rostral orbit, may cause intense bleeding, and consequently the possibility of bacterial contamination of the orbital cavity. We are also aware that marbofloxacin is not a first-line antibiotic, but in selected cases it can be used in perioperative prophylaxis because of its broad spectrum of activity against gram-negative and gram-positive bacteria. So, the decision to use marbofloxacin immediately before surgery and for six more days postoperatively was based on the type and location of the surgery, and the risk that orbital infection could lead to severe disease. Topical antibiotic ointment was used to avoid superficial infections and facilitate wound healing by keeping the wound moist and by increasing the removal of debris.