Use of Presumptive Antibiotics following Tube Thoracostomy for Traumatic Hemopneumothorax in the Prevention of Empyema and Pneumonia-A Multi-Center Trial.
Maxwell, Robert A. MD; Campbell, Donald J. MD; Fabian, Timothy C. MD; Croce, Martin A. MD; Luchette, Fred A. MD; Kerwin, Andrew J. MD; Davis, Kimberly A. MD; Nagy, Kimberly MD; Tisherman, Samuel MD
Journal of Trauma-Injury Infection & Critical Care.
57(4):742-749, October 2004.
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Objective: To determine whether presumptive antibiotics reduce the risk of empyema or pneumonia following tube thoracostomy for traumatic hemopneumothorax.
Methods: A prospective, randomized, double-blind trial was performed comparing the use of cefazolin for duration of tube thoracostomy placement (Group A) versus 24 hours (Group B) versus placebo (Group C).
Results: A total of 224 patients received 229 tube thoracostomies. Logistic regression analysis revealed that duration of tube placement and thoracic acute injury score were predictive of empyema (p < 0.05). Empyema tended to occur more frequently in patients with penetrating injuries (p = 0.09). [chi]2 analysis showed pneumonia occurred significantly more frequently in blunt than penetrating injuries (p < 0.05). Presumptive antibiotic use did not significantly effect the incidence of empyema or pneumonia, although no empyemas occurred in Group A.
Conclusions: The incidence of empyema was low and the use of presumptive antibiotics did not appear to reduce the risk of empyema or pneumonia.
(C) 2004 Lippincott Williams & Wilkins, Inc.