Antibiotic Practice Patterns for Extremity Wound Infections among Blast-Injured Subjects.
Mil Med
; 185(Suppl 1): 628-636, 2020 01 07.
Article
em En
| MEDLINE
| ID: mdl-32074316
ABSTRACT
INTRODUCTION:
We examined antibiotic management of combat-related extremity wound infections (CEWI) among wounded U.S. military personnel (2009-2012).METHODS:
Patients were included if they sustained blast injuries, resulting in ≥1 open extremity wound, were admitted to participating U.S. hospitals, developed a CEWI (osteomyelitis or deep soft-tissue infections) within 30 days post-injury, and received ≥3 days of relevant antibiotic (s) for treatment.RESULTS:
Among 267 patients, 133 (50%) had only a CEWI, while 134 (50%) had a CEWI plus concomitant non-extremity infection. In the pre-diagnosis period (4-10 days prior to CEWI diagnosis), 95 (36%) patients started a new antibiotic with 28% of patients receiving ≥2 antibiotics. During CEWI diagnosis week (±3 days of diagnosis), 209 (78%) patients started a new antibiotic (71% with ≥2 antibiotics). In the week following diagnosis (4-10 days after CEWI diagnosis), 121 (45%) patients started a new antibiotic with 39% receiving ≥2 antibiotics. Restricting to ±7 days of CEWI diagnosis, patients commonly received two (35%) or three (27%) antibiotics with frequent combinations involving carbapenem, vancomycin, and fluoroquinolones.CONCLUSIONS:
Substantial variation in antibiotic prescribing patterns related to CEWIs warrants development of combat-related clinical practice guidelines beyond infection prevention, to include strategies to reduce the use of unnecessary antibiotics and improve stewardship.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Infecção dos Ferimentos
/
Padrões de Prática Médica
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Extremidades
Tipo de estudo:
Etiology_studies
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Guideline
/
Prognostic_studies
Limite:
Adult
/
Female
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Humans
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Male
País/Região como assunto:
America do norte
Idioma:
En
Revista:
Mil Med
Ano de publicação:
2020
Tipo de documento:
Article