title: Prophylactic antibiotics adversely affect nosocomial pneumonia in trauma patients.
abstract: BACKGROUND
  Little data are available regarding the impact that prolonged prophylactic antibiotic use (>48 hours) has on the development of nosocomial pneumonia. This retrospective study was conducted to assess the effect that prolonged prophylactic antibiotic use has on the development of nosocomial pneumonia and antibiotic use complications.
  
  
  METHODS
  The records of patients who contracted nosocomial pneumonia during mechanical ventilation were retrospectively reviewed. These patients then were classified into two groups: those who received prolonged prophylactic antibiotics before the diagnosis of pneumonia and those who did not receive antibiotics.
  
  
  RESULTS
  For the patients who received prolonged prophylactic antibiotics, the first pneumonia was diagnosed later, the causative organisms were more likely to be resistant or Gram-negative bacteria, and the incidence of antibiotic complications were two times greater than for patients who did not receive extended antibiotic prophylaxis.
  
  
  CONCLUSIONS
  Justification for the use and duration of prolonged (>48 hours) prophylactic antibiotics requires careful reevaluation because this practice is associated with significant clinical complications that lead to increased use of patient resources, lengthened hospital stay, and higher cost.
authors.affiliation: Department of Surgery, University of Louisville School of Medicine, Kentucky 40292, USA.
authors.forename: J Jason
authors.initials: JJ
authors.lastname: Hoth
authors.forename: Glen A
authors.initials: GA
authors.lastname: Franklin
authors.forename: Nicole A
authors.initials: NA
authors.lastname: Stassen
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Girard
authors.forename: Roman J
authors.initials: RJ
authors.lastname: Rodriguez
authors.forename: Jorge L
authors.initials: JL
authors.lastname: Rodriguez
mesh_terms: D000328:Adult; D000368:Aged; D019072:Antibiotic Prophylaxis / Q000009:adverse effects*; D003422:Critical Care; D003428:Cross Infection / Q000209:etiology* / Q000401:mortality / Q000628:therapy; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D015601:Injury Severity Score; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D018410:Pneumonia, Bacterial / Q000209:etiology* / Q000401:mortality / Q000628:therapy; D012121:Respiration, Artificial / Q000009:adverse effects*; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors; D014947:Wounds and Injuries / Q000150:complications* / Q000401:mortality / Q000628:therapy