Efficacy of short-course antibiotic prophylaxis after penetrating intestinal injury. A prospective randomized trial
E. P. Dellinger, M. J. Wertz, E. S. Lennard and M. R. Oreskovich
Infection is the leading cause of morbidity and mortality occurring more
than 48 hours after penetrating abdominal injury. Antibiotics are routinely
administered to patients with penetrating intestinal injuries and are
usually given for five days or more. We randomized 116 patients with
confirmed penetrating injuries of the colon and/or small bowel to receive
either 12 hours or five days of antibiotics. Age, sex, weapon, severity of
injury, and other risk factors were evenly distributed between groups.
Twenty-one patients (18%) developed trauma-related infections, 28 (24%) any
infection, and three (2.6%) died. There were no significant differences
between groups in any category of outcome. For patients with penetrating
intestinal or colonic injury, a 12-hour course of antibiotics is as
effective as a five-day course and has the advantage of lower cost and,
theoretically, fewer side effects.
