Duration of Preventive Antibiotic Administration for Penetrating Abdominal Trauma

Abstract

• Eighty-two patients with penetrating abdominal trauma and visceral injuries requiring laparotomy were prospectively randomized to receive either 12 hours or five days of penicillin G potassium and doxycycline hyclate beginning before operation. Distribution between groups was equivalent for all risk factors except shock, which was more prevalent in the 12-hour group. Antibiotics were first administered an average of 64 minutes following injury, and 90% of all patients had received antibiotics and were being operated on within 3 hours 15 minutes. Overall infection rates were 17% in patients with colon penetration, 14% in patients without colon penetration but with other intestinal penetration, and 0% in patients without intestinal penetration. Twelve-hour and five-day antibiotic regimens were comparable in the prevention of postoperative infectious complications following penetrating abdominal injuries. Intestinal penetration was the most important risk factor for development of infectious complications in this patient population. (Arch Surg 1982;117:200-205)