Prophylactic antibiotics in chest trauma: a meta-analysis of high-quality studies.
BACKGROUND
Use of antibiotics in patients with isolated chest trauma is controversial. Available studies offer contradictory results because of small sample sizes. However, information provided by recent randomized controlled trials (RCT) included in a systematic review and meta-analysis could help solve the controversy. We performed a systematic review using high-quality information related to the use of antibiotics in patients with a chest tube.


METHODS
We developed a systematic review to evaluate the effectiveness of prophylactic antibiotics in chest-trauma patients. Studies included were class I RCT comparing prophylactic antibiotics versus placebo in patients with isolated chest trauma. Main outcomes were posttraumatic empyema and pneumonia.


RESULTS
Five Class I studies were selected. There were statistically significant differences regarding the frequency of posttraumatic empyema (RR 0.19) and pneumonia (RR 0.44) in favor of the use of prophylactic antibiotics when compared with placebo.


CONCLUSIONS
The use of prophylactic antibiotics in patients with chest trauma decreases the incidence of posttraumatic empyema and pneumonia.
Sanabria
Alvaro
A
Department of Surgery, School of Medicine, Pontificia Universidad Javeriana-Hospital Universitario San Ignacio, Cra 7 N 40-62 Of 718, Bogotá, Colombia. alvarosanabria@gmail.com
Valdivieso
Eduardo
E
Gomez
Gabriel
G
Echeverry
Gabriel
G
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis; D016724:Empyema, Pleural / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D011014:Pneumonia / Q000209:etiology / Q000517:prevention & control*; D011656:Pulmonary Emphysema / Q000209:etiology / Q000517:prevention & control*; D013898:Thoracic Injuries / Q000150:complications*; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents