Azithromycin versus Cephalexin for Simple Traumatic Wounds in the Emergency Department: A Randomised Trial

The aim of this study was to investigate efficacy of azithromycin versus cephalexin for infection prophylaxisis in patients with simple traumatic wounds managed at emergency department.

This randomized controlled trial compared short-course therapy of once-daily azithromycin (500 mg before the wound repair followed by 250 mg/day for 5 days) with cephalexin (1000 mg before wound repair followed by 250 mg every 6 hours for 5 days) in the treatment of patients with simple traumatic wounds. A total of 366 patients were randomly selected for the study and 303 were evaluated for the final analysis.

On completion of therapy, the rate of observed infection was 9.6% in the cephalexin group (15 patients, odds ratio=0.77, 95% confidence interval, 0.56 to 1.06) and 5.4% in the azithromycin group (8 patients, odds ratio 1.42, 95% confidence interval, 0.80 to 2.52). Both treatment indicated similar prophylactic efficacy during the study (P=0.197).

Our study showed that Azithromycin as infection prophylaxis in simple traumatic wounds had the same effect as cephalexin but azithromycin is easier to use and more cost-effective compared to cephalexin.