A prospective, randomised comparison of single-vs. multiple-dose antibiotic prophylaxis in penetrating trauma

This study was designed to compare the clinical efficacy of a single dose o f ceftriaxone with cefoxitin given 3 times a day for 3 days. Methods: Patie nts had to have a penetrating injury to only one part of the body, reach th e hospital within 2 h and be operated on within 16 h after the trauma. Pati ents were excluded if it appeared likely that they would require mechanical ventilation for more than 24 h. The same applies to open or grade II/III c raniocerebral trauma. The end point was the occurrence of infections within 10 days. The costs of antibiotic treatment were also calculated. Results: 96% of the ceftriaxone patients (n = 97) and 95% of the cefoxitin group (n = 98) remained infection-free. In neither treatment group was deep infectio n, abscess, phlegmon or sepsis seen. No additional surgery or intensive car e due to infection was required. At $41.83 vs. $172.16, the average total c ost of delivering antibiotic treatment was significantly lower in the ceftr iaxone group (p < 0.001). Conclusion: Prophylaxis in penetrating trauma wit h a single dose of ceftriaxone is safe and has considerable practical and e conomic advantages.