Evaluation of prophylactic antibiotics in penetrating brain injuries at an academic level 1 trauma center.

Autor: Marut D; Department of Pharmacy, Cleveland Clinic Avon Hospital, Avon, OH, USA. Electronic address: marutd@ccf.org., Shammassian B; Department of Neurological Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA., McKenzie C; Department of Pharmacy, University Hospitals Cleveland Medical Center, Cleveland, OH, USA., Adamski J; Department of Trauma Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA., Traeger J; Department of Pharmacy, University Hospitals Cleveland Medical Center, Cleveland, OH, USA.
Jazyk: angličtina
Zdroj: Clinical neurology and neurosurgery [Clin Neurol Neurosurg] 2020 Jun; Vol. 193, pp. 105777. Date of Electronic Publication: 2020 Mar 04.
DOI: 10.1016/j.clineuro.2020.105777
Abstrakt: Objective: Infections from penetrating brain injuries (PBI) lead to higher morbidity and mortality rates. The results of this research will be evaluated to develop institutional guideline for antibiotic prophylaxis in this patient population. The objective was to characterize the prophylactic antibiotic usage for patients presenting with PBI.
Patients and Methods: This retrospective chart review included patients with a PBI identified through the institution's trauma center registry between December 2015 and July 2018. The primary outcome was the proportion of patients that received prophylactic antibiotics. Secondary outcomes included antibiotic administration timing, selection and duration of antibiotic regimens, infection rates and patient outcomes.
Results: The study population included 33 patients, with 82 % males and an average age of 32 years. The most common mechanism of injury was a gunshot wound (94 %). Of the 33 patients, 24 (73 %) received at least one dose of prophylactic antibiotics. The median time to antibiotic administration was 52.8 min (IQR, 18-120), while the median duration of prophylaxis was 24 h (IQR, 7-84). The most common antibiotic regimen was a single cefazolin dose, with the next most common regimen included scheduled ceftriaxone and metronidazole. Overall, there were no documented central nervous system or skin and soft tissue infections during the initial admission, while 4 patients (12 %) were treated for pneumonia. Survivors (67 %) had a median hospital length of stay of 5.8 days.
Conclusion: The median duration of prophylaxis was shorter than the current data suggesting antibiotics for 5 days; however, there were no documented central nervous system infections, which is less than previously reported in the literature.
Competing Interests: Declaration of Competing Interest The authors have no conflicts of interest to disclose.
(Copyright © 2020 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: