Early Short-term Antibiotic Therapy in Penetrating Abdominal Trauma, 3 vs 7 Days
Status:
Completed
Trial end date:
2011-10-01
Target enrollment:
Participant gender:
Summary
Abdominal penetrating trauma represents a frequent cause of consult into emergency rooms in
Venezuela. Accidents and violence at Hospital "Miguel Perez Carreño" along april 2009 were
represented by gunshots and stabbing wounds which 8th. and 18th cause for medical attention
respectively within a total of 76 cases. Likewise gunshot wounds reach the first cause of
morbility into general surgery services with 21 cases and the stabbing wounds the 12th cause
with 12 cases within the same period.
Early therapy is defined as the antibiotic dose administrated within the first 12 hours after
the trauma. Abdominal cavity contamination by micro-organism is not synonymous of stablished
infection, the extension of contamination and intensity of reaction should be enough in order
to allow the inflammatory focus developing.
Abdominal cavity needs at least 12 - 24 hours of exposure to the infectious material to allow
the stablishment of such infection. Origin and amount of contaminant material influence the
size of inoculated bacteria and the speed that infection develops.
There is not an absolute criteria to determine when intrabdominal contamination progress to
an established infection. Surgeons decides the must adequated therapy according to clinical
history, radiology tests and findings during surgery.
Selected patients for early antibiotic therapy in penetrating abdominal trauma includes those
with traumatic intestinal wounds with less than 12 hours of evolution and those with
gastroduodenal wounds lesser than 24 hours as well.
There are different antibiotics indicated for intrabdominal infections. Ertapenem is a low
resistance carbapenem with a broad spectrum into microbial flora presenting in penetrating
abdominal trauma. Its media life and blood therapeutic levels allows the use of an unique
dose within the first 24 hours of trauma.
This research protocol has been designed according to established patterns for clinical
investigation and our goal is to achieve criteria in decision making about antibiotic
administration in patients with penetrating abdominal trauma and evaluate the security of an
Early short term antibiotic therapy with Ertapenem 3 days vs 7 days, decreasing hospital
costs related to indiscriminate use of antibiotics.