Routine antibiotic prophylaxis may not be necessary for many common eyelid and third eyelid procedures in dogs and cats, according to new research that could support more targeted antimicrobial use in practice.
The observational study, published in Veterinary Ophthalmology, found no increase in postoperative complications when antibiotics were withheld unless specific risk factors were present.
Researchers at the National Veterinary School of Alfort (France) evaluated 96 animals (71 dogs and 25 cats) undergoing 163 eyelid or third eyelid procedures over a 20-month period.
Cases were grouped based on antibiotic use:
Antibiotics were not given routinely. Instead, they were reserved for predefined risk factors such as:
Topical antibiotics were not used for surgical prophylaxis, but only where corneal ulceration was present.
Overall complication rates were low across all groups. Only two postoperative complications were reported:
Both cases involved moderate wound dehiscence and resolved with medical management alone. No systemic infections or severe complications were recorded.
Importantly, no clear reduction in complications was seen in animals receiving antibiotics. In fact, complication rates remained low even when no prophylaxis was used (1.4%).
This was a single-centre observational study with a relatively small sample size and a low number of complications, limiting statistical comparisons between groups.
Follow-up was also limited to 15 days, meaning later-onset infections may have been missed. In addition, not all cases were fully screened for underlying disease, which could influence infection risk.
The authors note that larger, prospective studies would be needed to confirm non-inferiority of withholding antibiotics.
Antimicrobial stewardship remains a key priority in UK veterinary medicine, yet antibiotic use in ophthalmic surgery is still widespread. This study adds to growing evidence that, in low-risk procedures, routine prophylaxis may offer limited benefit.
For first-opinion practices performing entropion corrections, mass removals or third eyelid surgeries, the findings suggest an opportunity to review prescribing protocols without compromising patient outcomes.