From the FDA Drug Label
Clindamycin is indicated in the treatment of serious infections caused by susceptible anaerobic bacteria. Clindamycin is also indicated in the treatment of serious infections due to susceptible strains of streptococci, pneumococci, and staphylococci Serious skin and soft tissue infections; Bacteriologic studies should be performed to determine the causative organisms and their susceptibility to clindamycin
The best antibiotic for postop skin biopsy is not explicitly stated in the label. Clindamycin may be considered for the treatment of serious skin and soft tissue infections, but bacteriologic studies should be performed to determine the causative organisms and their susceptibility to clindamycin 1.
From the Research
For a postoperative skin biopsy, prophylactic antibiotics are generally not routinely recommended for uncomplicated procedures, but if deemed necessary, cephalexin is often the first choice due to its efficacy against common skin flora, as supported by 2 and 3. Most clean, minor skin biopsies heal well without antibiotic prophylaxis. However, if antibiotics are deemed necessary due to specific risk factors (such as immunocompromised status, diabetes, biopsy in a high-risk area like the groin, or extensive procedure),
- cephalexin (Keflex) 500 mg orally four times daily for 5-7 days is often considered,
- alternatives for penicillin-allergic patients include clindamycin 300-450 mg orally three times daily or doxycycline 100 mg twice daily for the same duration, as these antibiotics provide good coverage against common skin flora including Staphylococcus aureus and Streptococcus species, which are the most likely pathogens in skin infections, as noted in 4. Proper wound care is equally important - keeping the site clean, dry, and covered with an appropriate dressing will often prevent infection without antibiotics. Signs that would warrant antibiotic treatment include increasing redness extending beyond the incision site, warmth, swelling, purulent drainage, or systemic symptoms like fever. It's also worth considering the findings of 5, which emphasize the importance of risk stratification and antibiotic stewardship in perioperative oral antibiotic use for dermatologic surgery, highlighting that oral antibiotic prophylaxis is overly prescribed for procedures involving the integumentary system. In line with 6, cephalosporins, such as cephalexin, are considered effective for surgical prophylaxis due to their broad-spectrum activity and lower risk of allergic reactions.