Ann Surg Treat Res.  2021 Feb;100(2):119-125. 10.4174/astr.2021.100.2.119.

Current status of initial antibiotic therapy and analysis of infections in patients with solitary abdominal trauma: a multicenter trial in Korea

Affiliations
  • 1Department of Traumatology, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
  • 2Department of Surgery and Trauma Center, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
  • 3Department of General Surgery, Haeundae Paik Hospital, Inje University, Busan, Korea
  • 4Department of Trauma Surgery, Korea University Guro Hospital, Seoul, Korea
  • 5Department of Trauma Surgery, Chungbuk National University Hospital, Cheongju, Korea
  • 6Department of Surgery, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Korea
  • 7Division of Acute Care Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
  • 8Department of Trauma Surgery, Uijeongbu St. Mary Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea

Abstract

Purpose
Proper use of antibiotics during emergency abdominal surgery is essential in reducing the incidence of surgical site infection. However, no studies have investigated the type of antibiotics and duration of therapy in individuals with abdominal trauma in Korea. We aimed to investigate the status of initial antibiotic therapy in patients with solitary abdominal trauma.
Methods
From January 2015 to December 2015, we retrospectively analyzed the medical records of patients with solitary abdominal trauma from 17 institutions including regional trauma centers in South Korea. Both blunt and penetrating abdominal injuries were included. Time from arrival to initial antibiotic therapy, rate of antibiotic use upon injury mechanism, injured organ, type, and duration of antibiotic use, and postoperative infection were investigated.
Results
Data of the 311 patients were collected. The use of antibiotic was initiated in 96.4% of patients with penetrating injury and 79.7% with blunt injury. Initial antibiotics therapy was provided to 78.2% of patients with solid organ injury and 97.5% with hollow viscus injury. The mean day of using antibiotics was 6 days in solid organ injuries, 6.2 days in hollow viscus. Infection within 2 weeks of admission occurred in 36 cases. Infection was related to injury severity (Abbreviated Injury Scale of >3), hollow viscus injury, operation, open abdomen, colon perforation, and RBC transfusion. There was no infection in cases with laparoscopic operation. Duration of antibiotics did not affect the infection rate.
Conclusion
Antibiotics are used extensively (84.2%) and for long duration (6.2 days) in patients with abdominal injury in Korea.

Keyword

Abdoimnal Injury; Anti-bacterial agents; Blunt injury; Penetrating injury
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