Role of antibiotics in penetrating abdominal trauma

The effectiveness of antibiotics in the management of penetrating abdominal injuries was studied retrospectively in two non-controlled, non-randomized groups of patients. The uncontrolled group (107 patients) received a variety of antibiotic(s) mainly intra- and postoperatively. The protocol group (121 patients) received a combination of clindamycin and gentamicin preoperatively in the Emergency Room. The protocol group had a statistically significant reduction in the incidence of intraabdominal sepsis, 1.7% as compared to 8.3% in the uncontrolled group. Although the improved results cannot be attributed solely to the antibiotic regimen, the trend seems apparent. Therefore, to minimize septic complications in penetrating abdominal injuries, we advocate: 1. prompt resuscitation, 2. early and appropriate surgical intervention and 3. preoperative antibiotics that are effective against both the aerobic and anerobic resident flora of the gastrointestinal tract.