title: Prophylactic antibiotic use in penetrating abdominal trauma: an Eastern Association for the Surgery of Trauma practice management guideline.
abstract: BACKGROUND
  The use of prophylactic antibiotics in penetrating abdominal trauma has resulted in decreased infection rates. The Eastern Association for the Surgery of Trauma (EAST) first published its practice management guidelines (PMGs) for the use of prophylactic antibiotics in penetrating abdominal trauma in 1998. During the next decade, several new prospective studies were published on this topic. In addition, the practice of damage control laparotomy became widely used, and additional questions arose as to the role of prophylactic antibiotics in this setting. Thus, the EAST Practice Management Guidelines Committee set out to update the original PMG.
  
  
  METHODS
  A search of the National Library of Medicine and the National Institutes of Health MEDLINE databases was performed using PubMed (www.pubmed.gov) and specific key words. The search retrieved English language articles regarding the use of antibiotics in penetrating abdominal trauma published from 1973 to 2011. The topics investigated were the need for perioperative antibiotics, the duration of antibiotic therapy, the dose of antibiotics in patients presenting in hemorrhagic shock, and the appropriate duration of antibiotic therapy in the setting of damage control laparotomy.
  
  
  RESULTS
  Forty-four articles were identified for inclusion in this review.
  
  
  CONCLUSIONS
  There is evidence to support a Level I recommendation that prophylactic antibiotics should only be administered for 24 hours in the presence of a hollow viscus injury. In addition, there are no data to support continuing prophylactic antibiotics longer than 24 hours in damage control laparotomy.
authors.affiliation: Division of Trauma, Virginia Commonwealth University Medical Center, Richmond, Virginia 23298, USA. sgoldberg@mcvh-vcu.edu
authors.forename: Stephanie R
authors.initials: SR
authors.lastname: Goldberg
authors.forename: Rahul J
authors.initials: RJ
authors.lastname: Anand
authors.forename: John J
authors.initials: JJ
authors.lastname: Como
authors.forename: Tracey
authors.initials: T
authors.lastname: Dechert
authors.forename: Christopher
authors.initials: C
authors.lastname: Dente
authors.forename: Fred A
authors.initials: FA
authors.lastname: Luchette
authors.forename: Rao R
authors.initials: RR
authors.lastname: Ivatury
authors.forename: Therese M
authors.initials: TM
authors.lastname: Duane
mesh_terms: D000007:Abdominal Injuries / Q000188:drug therapy*; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use; D019072:Antibiotic Prophylaxis / Q000379:methods / Q000592:standards*; D006801:Humans; D013997:Time Factors; D014950:Wounds, Penetrating / Q000188:drug therapy*
chemical_list: D000900:Anti-Bacterial Agents