BACKGROUND: The optimal duration of antibiotic use in penetrating abdominal trauma is incompletely defined. It is generally accepted that short-term antibiotics are appropriate for low-risk wounds. However, with colon injury and significant degree of injury, abdominal trauma index (ATI) more than 25, concern exists that short-term treatment is not adequate. METHODS: The study was a prospective double-blind trial of 24-hour treatment (cefoxitin or cefotetan) compared with 5-day treatment in 515 patients. Major abdominal infections (MAI) included abscess, necrotizing fasciitis, and diffuse peritonitis. RESULTS:MAI occurred in 8% of those patients with 1-day therapy and 10% with 5-day therapy. Subgroup analysis of high-risk groups (colon wounds and ATI of more than 25) showed the following MAI rates: colon, 1-day therapy, 14%; 5-day therapy, 15%; ATI of more than 25, 1-day therapy, 17%; 5-day therapy, 30%. CONCLUSIONS: Regardless of contamination and degree of injury, 24-hour antibiotic therapy is satisfactory for all penetrating abdominal trauma.
RCT Entities:
BACKGROUND: The optimal duration of antibiotic use in penetrating abdominal trauma is incompletely defined. It is generally accepted that short-term antibiotics are appropriate for low-risk wounds. However, with colon injury and significant degree of injury, abdominal trauma index (ATI) more than 25, concern exists that short-term treatment is not adequate. METHODS: The study was a prospective double-blind trial of 24-hour treatment (cefoxitin or cefotetan) compared with 5-day treatment in 515 patients. Major abdominal infections (MAI) included abscess, necrotizing fasciitis, and diffuse peritonitis. RESULTS: MAI occurred in 8% of those patients with 1-day therapy and 10% with 5-day therapy. Subgroup analysis of high-risk groups (colon wounds and ATI of more than 25) showed the following MAI rates: colon, 1-day therapy, 14%; 5-day therapy, 15%; ATI of more than 25, 1-day therapy, 17%; 5-day therapy, 30%. CONCLUSIONS: Regardless of contamination and degree of injury, 24-hour antibiotic therapy is satisfactory for all penetrating abdominal trauma.
Authors: Rebecca A Busch; Aaron F Heneghan; Joseph F Pierre; Joshua C Neuman; Claire A Reimer; Xinying Wang; Michelle E Kimple; Kenneth A Kudsk Journal: JPEN J Parenter Enteral Nutr Date: 2015-05-01 Impact factor: 4.016
Authors: Addison K May; Jacob S Brady; Joann Romano-Keeler; Wonder P Drake; Patrick R Norris; Judith M Jenkins; Richard J Isaacs; Erik M Boczko Journal: Chest Date: 2015-06 Impact factor: 9.410
Authors: E E Cornwell; W R Dougherty; T V Berne; G Velmahos; J A Murray; S Chahwan; H Belzberg; A Falabella; I R Morales; J Asensio; D Demetriades Journal: J Gastrointest Surg Date: 1999 Nov-Dec Impact factor: 3.452