Document Detail


Preventive antibiotic usage in traumatic thoracic injuries requiring closed tube thoracostomy.
MedLine Citation:
PMID:  7956409     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate the safety and effectiveness of antibiotics in reducing the infectious complications following closed tube thoracostomy for isolated chest trauma. DESIGN: Double-blind, randomized clinical trial. SETTING: Medical school affiliated large urban teaching hospital and trauma center. PATIENTS: One hundred nineteen of 159 patients over 18 years old presenting to the emergency department requiring closed tube thoracostomy for isolated chest injuries (113 penetrating, 6 blunt). INTERVENTION: Patients received either placebo or 1 g cefonicid daily intravenously started at chest tube insertion and stopped within 24 h of removal. MEASUREMENTS AND RESULTS: The development of wound infections, pneumonia (CDC criteria), or empyema; the incidence of adverse events; length of hospitalization. One nonspecific infection was seen in the cefonicid group (1.6 percent) and six respiratory tract infections (10.7 percent) in the placebo group (three empyema, one empyema with pneumonia, two pneumonia) (p = 0.0505; p = 0.0094 [excluding nonspecific infection]). No significant differences with antibiotic use were seen in the duration of chest tube use (p = 0.766), peak WBC counts (p = 0.108), lower peak temperatures (p = 0.063), or length of hospitalization (p = 0.165). Patients who developed infectious complications averaged approximately 8 days longer hospitalization than those without (p < 0.0001). CONCLUSION: This study showed that patients receiving antibiotics had a significantly reduced rate of infection than did patients administered placebo. No significant adverse events were seen in either group.
Authors:
R L Nichols; J W Smith; A C Muzik; E J Love; N E McSwain; G Timberlake; L M Flint
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Chest     Volume:  106     ISSN:  0012-3692     ISO Abbreviation:  Chest     Publication Date:  1994 Nov 
Date Detail:
Created Date:  1994-12-09     Completed Date:  1994-12-09     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1493-8     Citation Subset:  AIM; IM    
Affiliation:
Department of Surgery, Tulane University School of Medicine, New Orleans, LA 70112-2699.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Cefonicid / adverse effects,  therapeutic use*
Chest Tubes*
Chi-Square Distribution
Delayed-Action Preparations
Double-Blind Method
Female
Humans
Male
Middle Aged
Premedication* / statistics & numerical data
Prospective Studies
Statistics, Nonparametric
Surgical Wound Infection / prevention & control
Thoracic Injuries / complications,  surgery*
Thoracostomy*
Wounds, Nonpenetrating / complications,  surgery*
Wounds, Penetrating / complications,  surgery*
Chemical
Reg. No./Substance:
0/Delayed-Action Preparations; 61270-58-4/Cefonicid

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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