Background: Antibiotic prophylaxis is frequently used for the prevention of infection at a distant site such as the heart valve or prosthetic joint. However, there are no published data describing how dermatologists manage patients ''at risk''.Objective: The purpose of this study is to document prophylactic antibiotic use by dermatologists.Methods: A total of 211 randomly selected community dermatologists and 69 academic dermatologic surgeons were surveyed by questionnaire to determine whether they would provide antibiotic prophylaxis in 20 different clinical situations.Results: This survey showed that under certain circumstances, almost all dermatologists provide antibiotic prophylaxis to prevent infection at a distant site. However, many dermatologists use antibiotics in settings with relatively little or no indication and confuse a prophylactic regimen with treatment of a superficial infection.Conclusion: This survey underscores the need for education and research into the prophylactic management of patients ''at risk'' who undergo dermatologic surgical procedures.