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Single dose IV Antibiotic for Low-Energy Extremity Gunshot Wounds: A Prospective Protocol
Mai P Nguyen1, Jonathan C Savakus1, Natasha M Simske1
1From the MetroHealth System, affiliated with Case Western Reserve University, Cleveland, OH.
Summary
A single IV antibiotic dose effectively minimizes infection risk for low-energy extremity gunshot wounds. Adherence to this protocol significantly reduced infection rates, showing its value in patient care.
Area of Science:
- Trauma Surgery
- Infectious Disease Prevention
- Antibiotic Stewardship
Background:
- Low-energy extremity gunshot wounds (GSWs) carry a risk of infection.
- Previous research suggests single-dose IV antibiotics may suffice without extensive debridement.
- Standardizing antibiotic protocols is crucial for effective infection control.
Purpose of the Study:
- To prospectively evaluate the infection rate in patients with low-energy extremity GSWs using a single IV antibiotic dose protocol.
- To determine the efficacy of a standardized single-dose antibiotic regimen in preventing infections.
Main Methods:
- A prospective study included 530 adults with low-energy extremity GSWs over 35 months.
- Patients received a single dose of first-generation cephalosporin; operative fractures got perioperative antibiotics.
- Infection outcomes were compared between protocol adherence and non-adherence groups.
Main Results:
- Deep infection rate was 0.8%, with a total infection rate of 11.1%.
- Adherence to the single-dose antibiotic protocol significantly reduced infection risk (OR=0.39, P=0.01).
- Additional antibiotics beyond the single dose did not further decrease infection rates.
Conclusions:
- A standardized single-dose IV antibiotic protocol is effective in minimizing infection after low-energy extremity GSWs.
- This protocol offers a valuable approach to infection prophylaxis in this patient population.
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