Efficacy of short-course antibiotic prophylaxis after penetrating intestinal injury. A prospective randomized trial

Infection is the leading cause of morbidity and mortality occurring more than 48 hours after penetrating abdominal injury. Antibiotics are routinely administered to patients with penetrating intestinal injuries and are usually given for five days or more. We randomized 116 patients with confirmed penetrating injuries of the colon and/or small bowel to receive either 12 hours or five days of antibiotics. Age, sex, weapon, severity of injury, and other risk factors were evenly distributed between groups. Twenty-one patients (18%) developed trauma-related infections, 28 (24%) any infection, and three (2.6%) died. There were no significant differences between groups in any category of outcome. For patients with penetrating intestinal or colonic injury, a 12-hour course of antibiotics is as effective as a five-day course and has the advantage of lower cost and, theoretically, fewer side effects.