Antimicrobial Prophylaxis in Trauma Patients

In the era of rising antimicrobial resistance and successful protocols for empiric and prophylactic antimicrobial therapy in elective surgical procedures, it is important to consider the specific needs of the trauma population based on injury location, severity, and environmental exposures. In this study, we aim to compare outcomes of high-activation trauma patients who received antibiotics during initial evaluation with those who did not.

A retrospective chart review of patients focusing on antimicrobial administration who presented as the highest trauma activation criteria during the year 2021 was conducted at a single urban institution. Patient demographic, injury, and outcome data ere collected through manual data abstraction from our institutional trauma registry.

Nearly half of all trauma patients in our study received antibiotics after initial evaluation and age was found to be significantly associated with antibiotic administration within the first 1.5 h. Young men with penetrating injuries were more likely to receive antibiotic treatment. Seventy-eight percent of patients who received early antibiotics underwent a procedure, while 61% of those who did not receive early antibiotics did not (P < 0.001).

These findings emphasize the importance of individualizing antibiotic treatment based on the patient's age and specific injury pattern. They also underscore the need for trauma providers to prioritize antibiotic stewardship.