Tube thoracostomy and trauma--antibiotics or not?

Area of Science:

• Trauma Surgery
• Thoracic Surgery
• Infectious Disease Prevention

Background:

• Debate exists on antibiotic use with tube thoracostomy for trauma.
• Chest tube placement is common for pneumo- and/or hemothorax in trauma patients.

Purpose of the Study:

• To evaluate the efficacy of prophylactic antibiotics in preventing infectious complications following tube thoracostomy for thoracic trauma.

Main Methods:

• Prospective randomized study involving 58 trauma patients requiring tube thoracostomy.
• Control group received no antibiotics; experimental group received cefoxitin prophylaxis.
• Infectious complications (pneumonia, empyema) were monitored.

Main Results:

• Infectious complications occurred in 29% of the no-antibiotic group versus 3% in the antibiotic group (p=0.0227).
• Staphylococcus aureus was the most common pathogen identified.
• Significant microbial conversion was observed in cultures.

Conclusions:

• Systemic prophylactic antibiotic therapy is strongly recommended for trauma patients undergoing tube thoracostomy.
• Antibiotics significantly decrease the incidence of post-thoracostomy infectious complications.
• This includes patients with blunt or penetrating thoracic trauma.