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  • Title: Duration of antibiotic therapy for penetrating abdominal trauma: a prospective trial.
    Author: Fabian TC, Croce MA, Payne LW, Minard G, Pritchard FE, Kudsk KA.
    Journal: Surgery; 1992 Oct; 112(4):788-94; discussion 794-5. PubMed ID: 1411952.
    Abstract:
    BACKGROUND: The optimal duration of antibiotic use in penetrating abdominal trauma is incompletely defined. It is generally accepted that short-term antibiotics are appropriate for low-risk wounds. However, with colon injury and significant degree of injury, abdominal trauma index (ATI) more than 25, concern exists that short-term treatment is not adequate. METHODS: The study was a prospective double-blind trial of 24-hour treatment (cefoxitin or cefotetan) compared with 5-day treatment in 515 patients. Major abdominal infections (MAI) included abscess, necrotizing fasciitis, and diffuse peritonitis. RESULTS: MAI occurred in 8% of those patients with 1-day therapy and 10% with 5-day therapy. Subgroup analysis of high-risk groups (colon wounds and ATI of more than 25) showed the following MAI rates: colon, 1-day therapy, 14%; 5-day therapy, 15%; ATI of more than 25, 1-day therapy, 17%; 5-day therapy, 30%. CONCLUSIONS: Regardless of contamination and degree of injury, 24-hour antibiotic therapy is satisfactory for all penetrating abdominal trauma.
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