PROPHYLACTIC ANTIBIOTICS IN TREATMENT OF PENETRATING CHEST WOUNDS - PROSPECTIVE DOUBLE-BLIND-STUDY

Abstract

Considerable controversy exists as to whether or not antibiotics should be administered prophylactically to patients with penetrating chest trauma. No prospective study of this problem was reported. Therefore, 75 patients with isolated, penetrating chest injury were randomized prospectively in a double-blind study. Group A patients (38 patients) were given 300 mg of clindamycin phosphate every 6 h, beginning with admission and lasting until 1 day following chest tube removal or for 5 days, whichever was shorter. Group B patients (37 patients) were given a placebo on the same schedule. The patients'' hospital course, fever, white blood count, culture data and roentgenograms were recorded serially. Clindamycin-treated patients had a significantly lower incidence of radiographic pneumonia, less fever and a lower incidence of positive pleural and wound cultures. They acquired empyema less frequently, required fewer operations and had a shorter period of hospitalization. Antibiotics may be useful as adjunctive therapy in the management of penetrating chest trauma.