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Ceftriaxone (Rocephin) in abdominal trauma.
L C van Rensburg1, B Warren, V Warren
1Department of Surgery, Faculty of Medicine, University of Stellenbosch, Republic of South Africa.
The Journal of Trauma
|November 1, 1991
Summary
Ceftriaxone, combined with metronidazole, effectively prevented intra-abdominal sepsis in abdominal trauma patients. This 24-hour antibiotic regimen proved convenient and adequate, matching previous protocols in cost and efficacy.
Area of Science:
- Infectious Diseases
- Trauma Surgery
- Pharmacology
Background:
- Evaluating antibiotic efficacy in high-volume trauma centers is crucial.
- Traditional 6-hourly regimens in trauma patients often lead to missed doses.
- Ceftriaxone's long half-life offers potential for improved adherence and sustained therapeutic levels.
Observation:
- A prospective study assessed ceftriaxone combined with metronidazole in 290 abdominal trauma patients.
- The study considered stab wounds, missile injuries, and blunt trauma.
- Mean delay between injury and initial antibiotic dose was 9.1 hours.
Findings:
- Intra-abdominal sepsis did not occur in any patients.
- Wound infection rate was low at 1.4% (4 patients).
- Respiratory infections occurred in 12% of patients, with no associated deaths.
Implications:
- A 24-hour ceftriaxone regimen is a convenient and adequate strategy for preventing intra-abdominal sepsis in abdominal trauma.
- This approach simplifies antibiotic administration in busy trauma settings.
- The cost-effectiveness of this regimen is comparable to traditional multi-dose protocols.