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Antibiotics for pelvic fracture

docrickfry at aol.com docrickfry at aol.com
Thu Apr 13 18:38:39 BST 2006


I think many of us would like to see the data on which this pure conjecture is based--I understand the rationale that seems to make sense to you, but what is missing to justify such a potentially harmful intervention to the patient is the data showing it to be true.  And again, as dictated by the tenets of science and evidence-based medicine, such intervention is not justified UNTIL benefit is shown.  That is what is safest for the patient.  Once again, we are the patient's worst enemy with regard to the terrible spread of antibiotic resistance and life threatening infections around the world.
ERF 
 
-----Original Message-----
From: Michael Ferker <xg2k2 at yahoo.com>
To: Trauma &amp, Critical Care mailing list <trauma-list at trauma.org>
Sent: Thu, 13 Apr 2006 09:45:41 -0700 (PDT)
Subject: Re: Antibiotics for pelvic fracture


A trauma that would lead to an acetabular fracture would most likely call for an 
AB regimen in the assumption that something might've gone in through the trauma. 
Considering that you don't always know exactly how, where, or with what the 
trauma was incurred, administering ABs ASAP would be the only clear way of 
inhibiting sepsis.

-Mike F

bensonblues at comcast.net wrote: Tim, The reference for A/Bs in pelvic fractures 
is Management of Trauma: Pittfalls and Practice, Walt and Wilson, 2nd Ed., 
pp596-7. " Efforts to prevent pelvic sepsis are important...it is not clear how 
long such antibiotics should be given, 4-6 days should be adequate." They also 
reference Siebel, et. al,: Pelvic Fracture, in Clinical Care and 
Pathophysiology, 1987; Peltier: Complications associated with fractures of the 
pelvis, J Bone Joint Surg 1965, and Trunkey, et al: Management of pelvic 
fractures in blunt trauma injury, J Trauma 1974. But, if you say they are not 
indicated, that's okay. Right or wrong, I'm a lowly ER doc who, if initially 
treating a blunt trauma victim with an acetabular fracture, would be be inclined 
to give antibiotics in the ED in anticiption of intraabdominal injuries. DB
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