More is Not Better: Implications of Antibiotic Practice Management Guidelines for Penetrating Trauma Hollow Viscus Injury in a Level I Trauma Center

Sepsis remains a significant cause of morbidity and mortality for patients with penetrating abdominal injuries and may be caused by unrecognized or undertreated SSIs.1, 2 Incidence of sepsis after traumatic injury has been reported between 1 and 20 per cent, with higher rates of sepsis occurring in penetrating trauma.3 Appropriate use of antimicrobials, following the Eastern Association for the Surgery of Trauma (EAST) guidelines, has reduced the overall rate of SSI.4 Current recommendations include a single preoperative dose of prophylactic antibiotics with broadspectrum aerobic and anaerobic coverage as a standard of care for trauma patients sustaining penetrating abdominal wounds. Risk factors evaluated for development of SSI included type of the hollow viscus organ injured, injury type, presenting vital signs, blood transfusion requirement, time to surgery, ostomy formation, wound closure, and hospital length of stay (LOS). [...]this study confirms the validity of the current EAST guidelines and stresses the importance of protocol implementation to ensure consistent guideline compliance to improve the quality of care to surgical patients.