Maximizing Adherence and Minimizing Time to Antibiotics: A Multidisciplinary Institutional Trauma Bay Protocol for...

Area of Science:

• Trauma Surgery
• Infectious Disease Prevention
• Clinical Protocol Optimization

Background:

• Timely antibiotic administration is crucial for preventing infection in open fractures (openFx).
• Variability in antibiotic prophylaxis protocols can lead to delays in treatment during trauma activations.

Purpose of the Study:

• To evaluate the effectiveness of a multidisciplinary institutional protocol in optimizing antibiotic (Abx) administration time for open fractures.
• To assess improvements in Abx prophylaxis compliance during trauma activation.

Main Methods:

• Retrospective pre-post study design at a Level II Trauma Center.
• Compared patients treated before (pregroup) and after (postgroup) protocol implementation.
• Included patients with suspected openFx undergoing trauma activation, excluding appendicular skeleton fractures.

Main Results:

• The protocol significantly reduced mean time to Abx administration from 87.9 minutes to 22.2 minutes (P < 0.001).
• Compliance with Abx administration within 60 minutes increased from 53% to 96% (P < 0.001).
• Post hoc analysis confirmed the study was powered at 92% to detect this significant difference.

Conclusions:

• A multidisciplinary institutional protocol is effective in optimizing antibiotic administration time for open fractures.
• This protocol can be implemented in other trauma centers to improve outcomes for open fracture patients.