Duration of preventive antibiotic administration for penetrating abdominal trauma
M. R. Oreskovich, E. P. Dellinger, E. S. Lennard, M. Wertz, C. J. Carrico and B. H. Minshew
Eighty-two patients with penetrating abdominal trauma and visceral injuries
requiring laparotomy were prospectively randomized to receive either 12
hours or five days of penicillin G potassium and doxycycline hyclate
beginning before operation. Distribution between groups was equivalent for
all risk factors except shock, which was more prevalent in the 12-hour
group. Antibiotics were first administered an average of 64 minutes
following injury, and 90% of all patients had received antibiotics and were
being operated on within 3 hours 15 minutes. Overall infection rates were
17% in patients with colon penetration, 14% in patients without colon
penetration but with other intestinal penetration, and 0% in patients
without intestinal penetration. Twelve-hour and five-day antibiotic
regimens were comparable in the prevention of postoperative infectious
complications following penetrating abdominal injuries. Intestinal
penetration was the most important risk factor for developmental of
infectious complications in this patient population.
