title: Characteristics of prophylactic antibiotic strategies after penetrating abdominal trauma at a level I urban trauma center: a comparison with the East guidelines.
abstract: BACKGROUND
  Antibiotic prophylaxis, along with surgical intervention, is a key component in reducing infection in patients after penetrating abdominal trauma (PAT). Recent guidelines from the Eastern Association for the Surgery of Trauma (EAST) recommend that prophylaxis for < or = 24 hours is adequate for most patients. We compared antibiotic prophylaxis practices after PAT at our institution with EAST guidelines, quantified the incidence of infection, and identified risk factors for infection.
  
  
  METHODS
  This study was a retrospective review of patients with PAT requiring a therapeutic laparotomy between July 1998 and January 2001.
  
  
  RESULTS
  Antibiotic prophylaxis met EAST guidelines criteria in 21 of 97 patients (22%). There was a trend toward higher infection rates (18 of 76 vs. 3 of 21; = 0.273) when prophylaxis exceeded EAST recommendations. Multivariate analysis revealed blood transfusions to be the only predictor of infection (odds ratio, 6.9; 95% confidence interval, 2.42-19.95).
  
  
  CONCLUSIONS
  Despite prophylactic antibiotic use often exceeding EAST criteria, many patients still developed infection. Blood transfusion was the only significant risk factor for infection.
authors.affiliation: Department of Pharmacy Services, Wayne State University, Detroit, Michigan, USA.
authors.forename: George
authors.initials: G
authors.lastname: Delgado
authors.forename: Jeffrey F
authors.initials: JF
authors.lastname: Barletta
authors.forename: Salmaan
authors.initials: S
authors.lastname: Kanji
authors.forename: James G
authors.initials: JG
authors.lastname: Tyburski
authors.forename: Robert F
authors.initials: RF
authors.lastname: Wilson
authors.forename: John W
authors.initials: JW
authors.lastname: Devlin
mesh_terms: D000007:Abdominal Injuries / Q000601:surgery*; D000328:Adult; D019072:Antibiotic Prophylaxis; D003428:Cross Infection / Q000517:prevention & control; D004064:Digestive System / Q000293:injuries; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D012307:Risk Factors; D065227:Transfusion Reaction; D014946:Wound Infection / Q000517:prevention & control*; D014950:Wounds, Penetrating / Q000601:surgery*