A Comparison between Single-Dose and Five-Day Prophylactic Antibiotic Treatments on Simple Traumatic and Contaminated Wounds

Document Type : Original Article (s)

Authors

1 Research Instructor, Iranian Center for Evidence-Based Medicine (ICEBM) and Research Center for Pharmaceutical Nanotechnology (RCPN), Tabriz University of Medical Sciences, Tabriz, Iran

2 Assistant Professor, Department of Emergency, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran

3 Assistant Professor, Department of Emergency, Rasul-Akram Hospital, Tehran University of Medical Sciences, Tehran, Iran

4 Emergency Specialist, Department of Emergency, Rasul-Akram Hospital, Tehran University of Medical Sciences, Tehran, Iran

Abstract

Background: The primary goal of wound management is to achieve a functional closure with minimal scarring. One of the ways of wound management is to prescribe prophylactic antibiotics. This study compared single-dose intravenous (IV) prophylactic antibiotic with the common five-day treatment in simple traumatic and contaminated wounds.Methods: All patients with simple traumatic and contaminated wounds that were sutured and determined to have indications for prophylactic antibiotic therapy by a physician at emergency wards of Shohadaye Haftom-e-Tir and Rasoul-Akram Hospitals during working shifts of researchers were divided into two groups. The first group received a single-dose of IV cefazolin and the second group was treated with oral cephalexin for five days. Infection symptoms such as erythema, pus secretion and swelling were described to the patients. Patients were suggested to inform the researchers whenever they saw the symptoms before the exact date of suture removal.Findings: In this research, 150 patients were studied in two groups of 75. The first group received a single-dose IV antibiotic while the second received five days of antibiotic. Infection was observed in 6 (8%) and 7 (9.33%) patients in the first and second group, respectively. However, the two groups were not significantly different in terms of infection rate. Conclusion: The period of prophylactic antibiotic therapy does not seem to make significant differences in treatment of wounds. Therefore, based on the findings of previous studies, as well as ours, it can be concluded that using a single-dose IV prophylactic antibiotic might be preferable because it is more acceptable by patients and has fewer side effects.

Keywords

References

  1. Nakamura Y, Daya M. Use of appropriate antimicrobials in wound management. Emerg Med Clin North Am 2007; 25(1): 159-76.
  2. Hoth JJ, Franklin GA, Stassen NA, Girard SM, Rodriguez RJ, Rodriguez JL. Prophylactic antibiotics adversely affect nosocomial pneumonia in trauma patients. J Trauma 2003; 55(2): 249-54.
  3. Harbarth S, Samore MH, Lichtenberg D, Carmeli Y. Prolonged antibiotic prophylaxis after cardiovascular surgery and its effect on surgical site infections and antimicrobial resistance. Circulation 2000; 101(25): 2916-21.
  4. Becker A, Koltun L, Sayfan J. Impact of antimicrobial prophylaxis duration on wound infection in mesh repair of incisional hernia Çô preliminary results of a prospective randomized trial. European Surgery 2008; 40(1): 37-40.
  5. Cornwell EE, III, Dougherty WR, Berne TV, Velmahos G, Murray JA, Chahwan S, et al. Duration of antibiotic prophylaxis in high-risk patients with penetrating abdominal trauma: a prospective randomized trial. J Gastrointest Surg 1999; 3(6): 648-53.
  6. Perelman VS, Francis GJ, Rutledge T, Foote J, Martino F, Dranitsaris G. Sterile versus nonsterile gloves for repair of uncomplicated lacerations in the emergency department: a randomized controlled trial. Ann Emerg Med 2004; 43(3): 362-70.
  7. Singer AJ, Hollander JE, Quinn JV. Evaluation and management of traumatic lacerations. N Engl J Med 1997; 337(16): 1142-8.
  8. Cruse PJ, Foord R. A five-year prospective study of 23,649 surgical wounds. Arch Surg 1973; 107(2): 206-10.
  9. Holtom PD. Antibiotic prophylaxis: current recommendations. J Am Acad Orthop Surg 2006; 14(10 Spec No.): S98-100.
  10. Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR. Guideline for prevention of surgical site infection, 1999. Hospital Infection Control Practices Advisory Committee. Infect Control Hosp Epidemiol 1999; 20(4): 250-78.
  11. Thirlby RC, Blair AJ, III, Thal ER. The value of prophylactic antibiotics for simple lacerations. Surg Gynecol Obstet 1983; 156(2): 212-6.
  12. Cummings P, Del Beccaro MA. Antibiotics to prevent infection of simple wounds: a meta-analysis of randomized studies. Am J Emerg Med 1995; 13(4): 396-400.
Journal of Isfahan Medical School
Volume 29, Issue 160 - Serial Number 160
September and October 2011
Pages 1744-1749

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History

  • Receive Date: 29 July 2011
  • Revise Date: 05 May 2024
  • Accept Date: 06 April 2022

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