Mohs Surgery Medication

Updated: Jan 22, 2016
  • Author: Shang I Brian Jiang, MD; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Medication

Medication Summary

The goals of pharmacotherapy are to reduce morbidity and prevent complications.

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Antibiotics

Class Summary

Prophylactic antibiotics are recommended when the surgical site is considered high risk for surgical infection, including the oral mucosa, genitalia, and lower extremities below the knee.

Dicloxacillin

Dicloxacillin is used for the treatment of infections caused by penicillinase-producing staphylococci. It may be used to initiate therapy when staphylococcal infection is suspected.

Cephalexin (Keflex)

Cephalexin is a first-generation cephalosporin that arrests bacterial growth by inhibiting bacterial cell wall synthesis. It has bactericidal activity against rapidly growing organisms. Its primary activity is against skin flora, and it is used for skin infections or prophylaxis in minor procedures.

Clindamycin (Cleocin)

Clindamycin is a lincosamide for the treatment of serious skin and soft-tissue staphylococcal infections. It is also effective against aerobic and anaerobic streptococci (except enterococci). Clindamycin inhibits bacterial growth, possibly by blocking dissociation of peptidyl transfer ribonucleic acid (tRNA) from ribosomes, causing RNA-dependent protein synthesis to arrest.

Doxycycline (Adoxa, Doryx, Vibramycin, Monodox)

Doxycycline is a broad-spectrum, synthetically derived bacteriostatic antibiotic in the tetracycline class. It is almost completely absorbed, concentrates in bile, and is excreted in urine and feces as a biologically active metabolite in high concentrations.

It inhibits protein synthesis and, thus, bacterial growth by binding to 30S and possibly 50S ribosomal subunits of susceptible bacteria. It may block dissociation of peptidyl t-RNA from ribosomes, causing RNA-dependent protein synthesis to arrest. The adult dosage is 100 mg orally twice daily. Severe hepatic dysfunction is a contraindication.

Azithromycin (Zithromax, Zmax)

Azithromycin t is used to treat mild-to-moderate microbial infections. In adults, it is given in a single dose of 1 g orally. Azithromycin acts by binding to 50S ribosomal subunit of susceptible microorganisms and blocks dissociation of peptidyl tRNA from ribosomes, causing RNA-dependent protein synthesis to arrest. Nucleic acid synthesis is not affected. It concentrates in phagocytes and fibroblasts, as demonstrated by in vitro incubation techniques. In vivo studies suggest that concentration in phagocytes may contribute to drug distribution to inflamed tissues.

Trimethoprim and sulfamethoxazole (Bactrim, Bactrim DS, Septra DS)

Trimethoprim/sulfamethoxazole inhibits bacterial growth by inhibiting the synthesis of dihydrofolic acid. The antibacterial activity of trimethoprim/sulfamethoxazole includes common urinary tract pathogens, except Pseudomonas aeruginosa.

Ciprofloxacin (Cipro)

Ciprofloxacin is a fluoroquinolone with activity against most gram-negative organisms but no activity against anaerobes. It inhibits bacterial DNA synthesis and consequently growth.

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