Single dose IV Antibiotic for Low-Energy Extremity Gunshot Wounds
Objective:. To prospectively determine infection rate following low-energy extremity GSWs with a single dose IV antibiotic protocol. Summary Background Data:. Previous work suggests that a single IV antibiotic dose, without formal surgical debridement, mitigates infection risk. Methods:. Over 35 mon...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Health
2022-03-01
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| Series: | Annals of Surgery Open |
| Online Access: | http://journals.lww.com/10.1097/AS9.0000000000000136 |
| _version_ | 1797732826850787328 |
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| author | Mai P. Nguyen, MD Jonathan C. Savakus, MD Natasha M. Simske, BS Michael S. Reich, MD Ryan Furdock, MD Joseph F. Golob, Jr., MD Amy A. McDonald, MD John J. Como, MD, MPH Heather A. Vallier, MD |
| author_facet | Mai P. Nguyen, MD Jonathan C. Savakus, MD Natasha M. Simske, BS Michael S. Reich, MD Ryan Furdock, MD Joseph F. Golob, Jr., MD Amy A. McDonald, MD John J. Como, MD, MPH Heather A. Vallier, MD |
| author_sort | Mai P. Nguyen, MD |
| collection | DOAJ |
| description | Objective:. To prospectively determine infection rate following low-energy extremity GSWs with a single dose IV antibiotic protocol.
Summary Background Data:. Previous work suggests that a single IV antibiotic dose, without formal surgical debridement, mitigates infection risk.
Methods:. Over 35 months 530 adults with low-energy GSWs to the extremities were included. Three hundred fifty-two patients (66%) had ≥30 days follow-up. Patients were administered a single dose of first-generation IV cephalosporin antibiotics, and those with operative fractures received 24-hour perioperative antibiotics. Injury characteristics, treatment, protocol adherence, and outcomes (infection) were assessed between the protocol group (single-dose antibiotics) and the non-protocol group (no antibiotics or extra doses of antibiotics).
Results:. Compliance with the single-dose protocol occurred in 66.8%, while 33.2% received additional antibiotics or no antibiotics. The deep infection rate requiring surgical debridement was 0.8%, while the combined rate of all infections was 11.1%. Age, sex, injury location, multiple injuries, fracture presence, and type of surgery did not affect infection rate. Adherence to the antibiotic protocol was associated with a reduction in infection risk (odds ratio = 0.39, 95% confidence interval 0.19–0.83, P = 0.01). Receipt of additional antibiotics outside of our single-dose protocol did not predict further reduction in rate of infection (P = 0.64).
Conclusions:. A standardized protocol of single-dose IV antibiotic appears effective in minimizing infection after low-energy GSW to the extremities.
Level of Evidence:. Therapeutic Level II. |
| first_indexed | 2024-03-12T12:20:09Z |
| format | Article |
| id | doaj.art-ed34d6f752a64d0e9635fe1d9e379a86 |
| institution | Directory Open Access Journal |
| issn | 2691-3593 |
| language | English |
| last_indexed | 2024-03-12T12:20:09Z |
| publishDate | 2022-03-01 |
| publisher | Wolters Kluwer Health |
| record_format | Article |
| series | Annals of Surgery Open |
| spelling | doaj.art-ed34d6f752a64d0e9635fe1d9e379a862023-08-30T06:09:44ZengWolters Kluwer HealthAnnals of Surgery Open2691-35932022-03-0131e13610.1097/AS9.0000000000000136202203000-00027Single dose IV Antibiotic for Low-Energy Extremity Gunshot WoundsMai P. Nguyen, MD0Jonathan C. Savakus, MD1Natasha M. Simske, BS2Michael S. Reich, MD3Ryan Furdock, MD4Joseph F. Golob, Jr., MD5Amy A. McDonald, MD6John J. Como, MD, MPH7Heather A. Vallier, MD8From the * MetroHealth System, affiliated with Case Western Reserve University, Cleveland, OH.From the * MetroHealth System, affiliated with Case Western Reserve University, Cleveland, OH.From the * MetroHealth System, affiliated with Case Western Reserve University, Cleveland, OH.From the * MetroHealth System, affiliated with Case Western Reserve University, Cleveland, OH.From the * MetroHealth System, affiliated with Case Western Reserve University, Cleveland, OH.From the * MetroHealth System, affiliated with Case Western Reserve University, Cleveland, OH.From the * MetroHealth System, affiliated with Case Western Reserve University, Cleveland, OH.From the * MetroHealth System, affiliated with Case Western Reserve University, Cleveland, OH.From the * MetroHealth System, affiliated with Case Western Reserve University, Cleveland, OH.Objective:. To prospectively determine infection rate following low-energy extremity GSWs with a single dose IV antibiotic protocol. Summary Background Data:. Previous work suggests that a single IV antibiotic dose, without formal surgical debridement, mitigates infection risk. Methods:. Over 35 months 530 adults with low-energy GSWs to the extremities were included. Three hundred fifty-two patients (66%) had ≥30 days follow-up. Patients were administered a single dose of first-generation IV cephalosporin antibiotics, and those with operative fractures received 24-hour perioperative antibiotics. Injury characteristics, treatment, protocol adherence, and outcomes (infection) were assessed between the protocol group (single-dose antibiotics) and the non-protocol group (no antibiotics or extra doses of antibiotics). Results:. Compliance with the single-dose protocol occurred in 66.8%, while 33.2% received additional antibiotics or no antibiotics. The deep infection rate requiring surgical debridement was 0.8%, while the combined rate of all infections was 11.1%. Age, sex, injury location, multiple injuries, fracture presence, and type of surgery did not affect infection rate. Adherence to the antibiotic protocol was associated with a reduction in infection risk (odds ratio = 0.39, 95% confidence interval 0.19–0.83, P = 0.01). Receipt of additional antibiotics outside of our single-dose protocol did not predict further reduction in rate of infection (P = 0.64). Conclusions:. A standardized protocol of single-dose IV antibiotic appears effective in minimizing infection after low-energy GSW to the extremities. Level of Evidence:. Therapeutic Level II.http://journals.lww.com/10.1097/AS9.0000000000000136 |
| spellingShingle | Mai P. Nguyen, MD Jonathan C. Savakus, MD Natasha M. Simske, BS Michael S. Reich, MD Ryan Furdock, MD Joseph F. Golob, Jr., MD Amy A. McDonald, MD John J. Como, MD, MPH Heather A. Vallier, MD Single dose IV Antibiotic for Low-Energy Extremity Gunshot Wounds Annals of Surgery Open |
| title | Single dose IV Antibiotic for Low-Energy Extremity Gunshot Wounds |
| title_full | Single dose IV Antibiotic for Low-Energy Extremity Gunshot Wounds |
| title_fullStr | Single dose IV Antibiotic for Low-Energy Extremity Gunshot Wounds |
| title_full_unstemmed | Single dose IV Antibiotic for Low-Energy Extremity Gunshot Wounds |
| title_short | Single dose IV Antibiotic for Low-Energy Extremity Gunshot Wounds |
| title_sort | single dose iv antibiotic for low energy extremity gunshot wounds |
| url | http://journals.lww.com/10.1097/AS9.0000000000000136 |
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