Wound infection during the Yom Kippur war: observations concerning antibiotic prophylaxis and therapy
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Abstract:
Eighty-eight episodes of wound associated infection were identified among 624 consecutively admitted battlefield casualties. Ninety-one per cent of infections occurred during the administration of antibiotic therapy or prophylaxis and 65% were associated with the use of multiple antibacterial agents. Gram negative bacillary and mixed microbial infection predominated and were found to increase in relative incidence after the second day of hospitalization. Appropriate therapy, based on disc sensitivity testing, was administered in only 33% of infectious episodes. The practice of antibiotic wound prophylaxis may contribute to the incidence and nature of infection in battlefield wounds. Problems unique to the handling of battlefield wounded are discussed in comparing the present data with those of other war associated and civilian studies.
Insights
Antibiotic use in battlefield wound infections is common, with most infections occurring during antibiotic therapy. This practice may contribute to the rise of Gram-negative and mixed infections, necessitating careful antibiotic stewardship.
Area of Science:
- Military Medicine
- Infectious Diseases
- Wound Care
Background:
- Battlefield wounds present unique challenges for infection control.
- Antibiotic prophylaxis is frequently used in managing these injuries.
Purpose of the Study:
- To analyze the incidence and characteristics of wound-associated infections in battlefield casualties.
- To evaluate the role of antibiotic therapy and prophylaxis in the development of these infections.
Main Methods:
- Retrospective analysis of 88 wound-associated infection episodes in 624 battlefield casualties.
- Microbial analysis and antibiotic sensitivity testing were performed.
Main Results:
- 91% of infections occurred during antibiotic therapy or prophylaxis.
- 65% of infections involved multiple antibacterial agents.
- Gram-negative bacillary and mixed infections predominated, increasing after day two.
Conclusions:
- Antibiotic wound prophylaxis may increase the incidence and alter the nature of battlefield wound infections.
- Inappropriate therapy, based on sensitivity testing, was common.
- The findings highlight the need for optimized antibiotic strategies in managing battlefield wounds.