HOW MANY ANTIBIOTICS ARE NECESSARY TO TREAT ABDOMINAL-TRAUMA VICTIMS

We wanted to determine the value of single- veusus multiple-antibiotic treatment in cases of penetrating abdominal trauma. Of 357 patients e ntered into a prospective, randomized, examiner-blinded study, 291 met all protocol criteria; 101 of these patients received cefoperazone al one, 95 were given ceftriaxone with metronidazole, and 95 were placed on metronidazole, gentamicin, and ampicillin. Aerobic and anaerobic ba cterial cultures were obtained upon opening and closing the peritoneum . The three groups were found to be similar upon evaluation of key par ameters, such as the median number of febrile days, morbidity, incisio nal wound infection, intra-abdominal abscess, septicemia, other infect ions, hospital stay, and death. Fifteen of 291 (5%) patients had infec tious complications, and 12 (4.1%) developed noninfectious complicatio ns. There were six (2.1%) deaths, two in each antibiotic group. Noninf ectious complications occurred more frequently in the triple-antibioti c group, which was statistically significant (P = 0.013). There were n o therapeutic failures, and therefore, the routine usage of additional antibiotics to cover for enterococcus needs justification.