A prospective, randomised comparison of single- vs. multiple-dose antibiotic prophylaxis in penetrating trauma.
This study was designed to compare the clinical efficacy of a single dose of ceftriaxone with cefoxitin given 3 times a day for 3 days.


METHODS
Patients had to have a penetrating injury to only one part of the body, reach the hospital within 2 h and be operated on within 16 h after the trauma. Patients were excluded if it appeared likely that they would require mechanical ventilation for more than 24 h. The same applies to open or grade II/III craniocerebral trauma. The end point was the occurrence of infections within 10 days. The costs of antibiotic treatment were also calculated.


RESULTS
96% of the ceftriaxone patients (n = 97) and 95% of the cefoxitin group (n = 98) remained infection-free. In neither treatment group was deep infection, abscess, phlegmon or sepsis seen. No additional surgery or intensive care due to infection was required. At $41.83 vs. $172.16, the average total cost of delivering antibiotic treatment was significantly lower in the ceftriaxone group (p < 0.001).


CONCLUSIONS
Prophylaxis in penetrating trauma with a single dose of ceftriaxone is safe and has considerable practical and economic advantages.
Schmidt-Matthiesen
A
A
Department of Surgery, Johann Wolfgang Goethe University, Frankfurt am Main, Germany.
Röding
H
H
Windolf
J
J
Sommerfeldt
D
D
Gutt
C
C
Pannike
A
A
Encke
A
A
D000007:Abdominal Injuries / Q000150:complications / Q000601:surgery; D000328:Adult; D019072:Antibiotic Prophylaxis; D001424:Bacterial Infections / Q000188:drug therapy* / Q000209:etiology*; D002440:Cefoxitin / Q000008:administration & dosage* / Q000191:economics; D002443:Ceftriaxone / Q000008:administration & dosage* / Q000191:economics; D002511:Cephalosporins / Q000008:administration & dosage / Q000191:economics; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination / Q000008:administration & dosage*; D005121:Extremities / Q000293:injuries; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011552:Pseudomonas Infections / Q000188:drug therapy; D013203:Staphylococcal Infections / Q000188:drug therapy; D013898:Thoracic Injuries / Q000150:complications / Q000601:surgery; D014945:Wound Healing; D014950:Wounds, Penetrating / Q000150:complications* / Q000191:economics / Q000601:surgery
D002511:Cephalosporins; D002440:Cefoxitin; D002443:Ceftriaxone