Antibiotic Treatment – What Can Be Learned from Point of Injury Experience?
Abstract Introduction Early antibiotic administration after trauma reduces infection rates of open wounds. A clinical practice guideline (CPG) was created to ensure that wounded personnel who are not expected to arrive at the hospital within an hour receive antibiotic treatment in the field. This st...
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| Veröffentlicht in: | Military medicine 2018-03, Vol.183 (suppl_1), p.466-471 |
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| creator | Benov, Avi Antebi, Ben Wenke, Joseph C Batchinsky, Andriy I Murray, Clinton K Nachman, Dean Haim, Paran Tarif, Bader Glassberg, Elon Yitzhak, Avi |
| description | Abstract
Introduction
Early antibiotic administration after trauma reduces infection rates of open wounds. A clinical practice guideline (CPG) was created to ensure that wounded personnel who are not expected to arrive at the hospital within an hour receive antibiotic treatment in the field. This study evaluated how well-advanced life saver (ALS) providers complied with Israeli Defense Force (IDF) CPG.
Materials and Methods
A retrospective review of all trauma patients between November 2011 and January 2015 was conducted. All casualties who suffered from penetrating injuries with evacuation times greater than 60 min were examined. Casualties who should have received antibiotic treatment in accordance with the IDF CPG were further divided into those who received antibiotics (i.e., “Antibiotic” group) and those who did not receive antibiotic treatment (i.e., “No Antibiotics” group).
Results
For a 3-yr period, a total of 5,142 casualties occurred in the pre-hospital environment. According to parameters established in the CPG, 600 casualties should have received antibiotic treatment. Of these patients, only 49 (8.2%) received antibiotic treatment. Comparative analysis between these groups revealed no significant differences in regards to gender, age, and time to MTF; however, significant differences were found in regards to injury severity score (ISS) (p < 0.01), care under fire (i.e., treatment at a combat zone) criteria (p < 0.00001), and life-saving interventions (p < 0.005).
Discussion
Although the reasons for poor adherence to IDF CPG’s are not entirely clear, the data suggest that the severity of the injuries sustained by these casualties requiring a greater number of LSIs, longer evacuation distances, and a more hostile battlefield environment may each contribute to poor adherence. Since this has been identified as a training gap, the importance of antibiotic administration at point of injury in delayed evacuation scenarios has been reinforced. |
| doi_str_mv | 10.1093/milmed/usx144 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2024019187</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><oup_id>10.1093/milmed/usx144</oup_id><sourcerecordid>2430091918</sourcerecordid><originalsourceid>FETCH-LOGICAL-c421t-29e71093909b40ec6c265777b127453ea3bb7b2c0dbf48f4fa7bda246af7821f3</originalsourceid><addsrcrecordid>eNqFkctKxDAUhoMoOo4u3UrAjZvqyaXNZCU6eIMRXYzoriSdE-wwbcakBd35Dr6hT2LLKIILXR04fPz8F0L2GBwx0OK4KhcVzo7b-MKkXCMDpgUkGROP62QAwLNEgkq3yHaMcwAm9Yhtki2uM5GmqRqQm9O6KW3pm7Kg04CmqbBu6MfbO314Mg0dm5qeIZ2gCTXOqAu-one-7BDv6HU9b8MrPX9ZYiixLvBkh2w4s4i4-3WH5P7ifDq-Sia3l9fj00lSSM6ahGtUvXkN2krAIit4liqlLONKpgKNsFZZXsDMOjly0hllZ4bLzDg14syJITlc6S6Df24xNnlVxgIXC1Ojb2POgUtgmo1Uhx78Que-DXXnLudSAOge-5MCqbvWRNZrJSuqCD7GgC5fhrIy4TVnkPeB8tUa-WqNjt__Um1t__6mv-v_yeHb5T9anxOkk6g</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2049981367</pqid></control><display><type>article</type><title>Antibiotic Treatment – What Can Be Learned from Point of Injury Experience?</title><source>Oxford University Press Journals All Titles (1996-Current)</source><source>MEDLINE</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><creator>Benov, Avi ; Antebi, Ben ; Wenke, Joseph C ; Batchinsky, Andriy I ; Murray, Clinton K ; Nachman, Dean ; Haim, Paran ; Tarif, Bader ; Glassberg, Elon ; Yitzhak, Avi</creator><creatorcontrib>Benov, Avi ; Antebi, Ben ; Wenke, Joseph C ; Batchinsky, Andriy I ; Murray, Clinton K ; Nachman, Dean ; Haim, Paran ; Tarif, Bader ; Glassberg, Elon ; Yitzhak, Avi</creatorcontrib><description>Abstract
Introduction
Early antibiotic administration after trauma reduces infection rates of open wounds. A clinical practice guideline (CPG) was created to ensure that wounded personnel who are not expected to arrive at the hospital within an hour receive antibiotic treatment in the field. This study evaluated how well-advanced life saver (ALS) providers complied with Israeli Defense Force (IDF) CPG.
Materials and Methods
A retrospective review of all trauma patients between November 2011 and January 2015 was conducted. All casualties who suffered from penetrating injuries with evacuation times greater than 60 min were examined. Casualties who should have received antibiotic treatment in accordance with the IDF CPG were further divided into those who received antibiotics (i.e., “Antibiotic” group) and those who did not receive antibiotic treatment (i.e., “No Antibiotics” group).
Results
For a 3-yr period, a total of 5,142 casualties occurred in the pre-hospital environment. According to parameters established in the CPG, 600 casualties should have received antibiotic treatment. Of these patients, only 49 (8.2%) received antibiotic treatment. Comparative analysis between these groups revealed no significant differences in regards to gender, age, and time to MTF; however, significant differences were found in regards to injury severity score (ISS) (p < 0.01), care under fire (i.e., treatment at a combat zone) criteria (p < 0.00001), and life-saving interventions (p < 0.005).
Discussion
Although the reasons for poor adherence to IDF CPG’s are not entirely clear, the data suggest that the severity of the injuries sustained by these casualties requiring a greater number of LSIs, longer evacuation distances, and a more hostile battlefield environment may each contribute to poor adherence. Since this has been identified as a training gap, the importance of antibiotic administration at point of injury in delayed evacuation scenarios has been reinforced.</description><identifier>ISSN: 0026-4075</identifier><identifier>EISSN: 1930-613X</identifier><identifier>DOI: 10.1093/milmed/usx144</identifier><identifier>PMID: 29635557</identifier><language>eng</language><publisher>England: Oxford University Press</publisher><subject>Adult ; Anti-Bacterial Agents - administration & dosage ; Anti-Bacterial Agents - therapeutic use ; Antibiotics ; Casualties ; Clinical medicine ; Epidemiology ; Female ; Guidelines as Topic - standards ; Humans ; Infections ; Injuries ; Male ; Military medicine ; Military Medicine - methods ; Military Personnel - statistics & numerical data ; Mortality ; Point-of-Care Systems - standards ; Point-of-Care Systems - statistics & numerical data ; Registries - statistics & numerical data ; Retrospective Studies ; Sepsis ; Time Factors ; Trauma ; Wound healing ; Wounds and Injuries - drug therapy</subject><ispartof>Military medicine, 2018-03, Vol.183 (suppl_1), p.466-471</ispartof><rights>Association of Military Surgeons of the United States 2018. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com. 2018</rights><rights>Copyright Association of Military Surgeons of the United States Mar/Apr 2018</rights><rights>Association of Military Surgeons of the United States 2018. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c421t-29e71093909b40ec6c265777b127453ea3bb7b2c0dbf48f4fa7bda246af7821f3</citedby><cites>FETCH-LOGICAL-c421t-29e71093909b40ec6c265777b127453ea3bb7b2c0dbf48f4fa7bda246af7821f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,1578,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29635557$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Benov, Avi</creatorcontrib><creatorcontrib>Antebi, Ben</creatorcontrib><creatorcontrib>Wenke, Joseph C</creatorcontrib><creatorcontrib>Batchinsky, Andriy I</creatorcontrib><creatorcontrib>Murray, Clinton K</creatorcontrib><creatorcontrib>Nachman, Dean</creatorcontrib><creatorcontrib>Haim, Paran</creatorcontrib><creatorcontrib>Tarif, Bader</creatorcontrib><creatorcontrib>Glassberg, Elon</creatorcontrib><creatorcontrib>Yitzhak, Avi</creatorcontrib><title>Antibiotic Treatment – What Can Be Learned from Point of Injury Experience?</title><title>Military medicine</title><addtitle>Mil Med</addtitle><description>Abstract
Introduction
Early antibiotic administration after trauma reduces infection rates of open wounds. A clinical practice guideline (CPG) was created to ensure that wounded personnel who are not expected to arrive at the hospital within an hour receive antibiotic treatment in the field. This study evaluated how well-advanced life saver (ALS) providers complied with Israeli Defense Force (IDF) CPG.
Materials and Methods
A retrospective review of all trauma patients between November 2011 and January 2015 was conducted. All casualties who suffered from penetrating injuries with evacuation times greater than 60 min were examined. Casualties who should have received antibiotic treatment in accordance with the IDF CPG were further divided into those who received antibiotics (i.e., “Antibiotic” group) and those who did not receive antibiotic treatment (i.e., “No Antibiotics” group).
Results
For a 3-yr period, a total of 5,142 casualties occurred in the pre-hospital environment. According to parameters established in the CPG, 600 casualties should have received antibiotic treatment. Of these patients, only 49 (8.2%) received antibiotic treatment. Comparative analysis between these groups revealed no significant differences in regards to gender, age, and time to MTF; however, significant differences were found in regards to injury severity score (ISS) (p < 0.01), care under fire (i.e., treatment at a combat zone) criteria (p < 0.00001), and life-saving interventions (p < 0.005).
Discussion
Although the reasons for poor adherence to IDF CPG’s are not entirely clear, the data suggest that the severity of the injuries sustained by these casualties requiring a greater number of LSIs, longer evacuation distances, and a more hostile battlefield environment may each contribute to poor adherence. Since this has been identified as a training gap, the importance of antibiotic administration at point of injury in delayed evacuation scenarios has been reinforced.</description><subject>Adult</subject><subject>Anti-Bacterial Agents - administration & dosage</subject><subject>Anti-Bacterial Agents - therapeutic use</subject><subject>Antibiotics</subject><subject>Casualties</subject><subject>Clinical medicine</subject><subject>Epidemiology</subject><subject>Female</subject><subject>Guidelines as Topic - standards</subject><subject>Humans</subject><subject>Infections</subject><subject>Injuries</subject><subject>Male</subject><subject>Military medicine</subject><subject>Military Medicine - methods</subject><subject>Military Personnel - statistics & numerical data</subject><subject>Mortality</subject><subject>Point-of-Care Systems - standards</subject><subject>Point-of-Care Systems - statistics & numerical data</subject><subject>Registries - statistics & numerical data</subject><subject>Retrospective Studies</subject><subject>Sepsis</subject><subject>Time Factors</subject><subject>Trauma</subject><subject>Wound healing</subject><subject>Wounds and Injuries - drug therapy</subject><issn>0026-4075</issn><issn>1930-613X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BEC</sourceid><sourceid>BENPR</sourceid><recordid>eNqFkctKxDAUhoMoOo4u3UrAjZvqyaXNZCU6eIMRXYzoriSdE-wwbcakBd35Dr6hT2LLKIILXR04fPz8F0L2GBwx0OK4KhcVzo7b-MKkXCMDpgUkGROP62QAwLNEgkq3yHaMcwAm9Yhtki2uM5GmqRqQm9O6KW3pm7Kg04CmqbBu6MfbO314Mg0dm5qeIZ2gCTXOqAu-one-7BDv6HU9b8MrPX9ZYiixLvBkh2w4s4i4-3WH5P7ifDq-Sia3l9fj00lSSM6ahGtUvXkN2krAIit4liqlLONKpgKNsFZZXsDMOjly0hllZ4bLzDg14syJITlc6S6Df24xNnlVxgIXC1Ojb2POgUtgmo1Uhx78Que-DXXnLudSAOge-5MCqbvWRNZrJSuqCD7GgC5fhrIy4TVnkPeB8tUa-WqNjt__Um1t__6mv-v_yeHb5T9anxOkk6g</recordid><startdate>20180301</startdate><enddate>20180301</enddate><creator>Benov, Avi</creator><creator>Antebi, Ben</creator><creator>Wenke, Joseph C</creator><creator>Batchinsky, Andriy I</creator><creator>Murray, Clinton K</creator><creator>Nachman, Dean</creator><creator>Haim, Paran</creator><creator>Tarif, Bader</creator><creator>Glassberg, Elon</creator><creator>Yitzhak, Avi</creator><general>Oxford University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>4T-</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88F</scope><scope>88G</scope><scope>88I</scope><scope>8AF</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M1Q</scope><scope>M2M</scope><scope>M2P</scope><scope>NAPCQ</scope><scope>PHGZM</scope><scope>PHGZT</scope><scope>PJZUB</scope><scope>PKEHL</scope><scope>PPXIY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>S0X</scope><scope>7X8</scope></search><sort><creationdate>20180301</creationdate><title>Antibiotic Treatment – What Can Be Learned from Point of Injury Experience?</title><author>Benov, Avi ; Antebi, Ben ; Wenke, Joseph C ; Batchinsky, Andriy I ; Murray, Clinton K ; Nachman, Dean ; Haim, Paran ; Tarif, Bader ; Glassberg, Elon ; Yitzhak, Avi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c421t-29e71093909b40ec6c265777b127453ea3bb7b2c0dbf48f4fa7bda246af7821f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Adult</topic><topic>Anti-Bacterial Agents - administration & dosage</topic><topic>Anti-Bacterial Agents - therapeutic use</topic><topic>Antibiotics</topic><topic>Casualties</topic><topic>Clinical medicine</topic><topic>Epidemiology</topic><topic>Female</topic><topic>Guidelines as Topic - standards</topic><topic>Humans</topic><topic>Infections</topic><topic>Injuries</topic><topic>Male</topic><topic>Military medicine</topic><topic>Military Medicine - methods</topic><topic>Military Personnel - statistics & numerical data</topic><topic>Mortality</topic><topic>Point-of-Care Systems - standards</topic><topic>Point-of-Care Systems - statistics & numerical data</topic><topic>Registries - statistics & numerical data</topic><topic>Retrospective Studies</topic><topic>Sepsis</topic><topic>Time Factors</topic><topic>Trauma</topic><topic>Wound healing</topic><topic>Wounds and Injuries - drug therapy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Benov, Avi</creatorcontrib><creatorcontrib>Antebi, Ben</creatorcontrib><creatorcontrib>Wenke, Joseph C</creatorcontrib><creatorcontrib>Batchinsky, Andriy I</creatorcontrib><creatorcontrib>Murray, Clinton K</creatorcontrib><creatorcontrib>Nachman, Dean</creatorcontrib><creatorcontrib>Haim, Paran</creatorcontrib><creatorcontrib>Tarif, Bader</creatorcontrib><creatorcontrib>Glassberg, Elon</creatorcontrib><creatorcontrib>Yitzhak, Avi</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Docstoc</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Military Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>eLibrary</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Military Database</collection><collection>ProQuest Psychology</collection><collection>Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest Central (New)</collection><collection>ProQuest One Academic (New)</collection><collection>ProQuest Health & Medical Research Collection</collection><collection>ProQuest One Academic Middle East (New)</collection><collection>ProQuest One Health & Nursing</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>SIRS Editorial</collection><collection>MEDLINE - Academic</collection><jtitle>Military medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Benov, Avi</au><au>Antebi, Ben</au><au>Wenke, Joseph C</au><au>Batchinsky, Andriy I</au><au>Murray, Clinton K</au><au>Nachman, Dean</au><au>Haim, Paran</au><au>Tarif, Bader</au><au>Glassberg, Elon</au><au>Yitzhak, Avi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Antibiotic Treatment – What Can Be Learned from Point of Injury Experience?</atitle><jtitle>Military medicine</jtitle><addtitle>Mil Med</addtitle><date>2018-03-01</date><risdate>2018</risdate><volume>183</volume><issue>suppl_1</issue><spage>466</spage><epage>471</epage><pages>466-471</pages><issn>0026-4075</issn><eissn>1930-613X</eissn><abstract>Abstract
Introduction
Early antibiotic administration after trauma reduces infection rates of open wounds. A clinical practice guideline (CPG) was created to ensure that wounded personnel who are not expected to arrive at the hospital within an hour receive antibiotic treatment in the field. This study evaluated how well-advanced life saver (ALS) providers complied with Israeli Defense Force (IDF) CPG.
Materials and Methods
A retrospective review of all trauma patients between November 2011 and January 2015 was conducted. All casualties who suffered from penetrating injuries with evacuation times greater than 60 min were examined. Casualties who should have received antibiotic treatment in accordance with the IDF CPG were further divided into those who received antibiotics (i.e., “Antibiotic” group) and those who did not receive antibiotic treatment (i.e., “No Antibiotics” group).
Results
For a 3-yr period, a total of 5,142 casualties occurred in the pre-hospital environment. According to parameters established in the CPG, 600 casualties should have received antibiotic treatment. Of these patients, only 49 (8.2%) received antibiotic treatment. Comparative analysis between these groups revealed no significant differences in regards to gender, age, and time to MTF; however, significant differences were found in regards to injury severity score (ISS) (p < 0.01), care under fire (i.e., treatment at a combat zone) criteria (p < 0.00001), and life-saving interventions (p < 0.005).
Discussion
Although the reasons for poor adherence to IDF CPG’s are not entirely clear, the data suggest that the severity of the injuries sustained by these casualties requiring a greater number of LSIs, longer evacuation distances, and a more hostile battlefield environment may each contribute to poor adherence. Since this has been identified as a training gap, the importance of antibiotic administration at point of injury in delayed evacuation scenarios has been reinforced.</abstract><cop>England</cop><pub>Oxford University Press</pub><pmid>29635557</pmid><doi>10.1093/milmed/usx144</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Military medicine, 2018-03, Vol.183 (suppl_1), p.466-471 |
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| source | Oxford University Press Journals All Titles (1996-Current); MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals |
| subjects | Adult Anti-Bacterial Agents - administration & dosage Anti-Bacterial Agents - therapeutic use Antibiotics Casualties Clinical medicine Epidemiology Female Guidelines as Topic - standards Humans Infections Injuries Male Military medicine Military Medicine - methods Military Personnel - statistics & numerical data Mortality Point-of-Care Systems - standards Point-of-Care Systems - statistics & numerical data Registries - statistics & numerical data Retrospective Studies Sepsis Time Factors Trauma Wound healing Wounds and Injuries - drug therapy |
| title | Antibiotic Treatment – What Can Be Learned from Point of Injury Experience? |
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