Presumptive Antibiotic Administration And Chest Tube Insertion.

• Next message: Presumptive Antibiotic Administration And Chest Tube Insertion.
• Messages sorted by: [ date ] [ thread ] [ subject ] [ author ]

Agree with Dr Mattox...but...the problem is most of the papers have chosen the wrong end-point to study. Empyema is such an uncommon event that, as Ken points out, it would take a huge study to show a significant reduction. However, we looked at this 5 or so years ago in an effort to develop an internal consensus and there was literature that  suggested that antibiotic administration with a 1st generation cepha-drug was associated with a lower pneumonia rate. That has been our practice.
 
Jeffrey Hammond MD, MPH
New Brunswick, NJ

----- Original Message -----
From: KMATTOX at aol.com
Date: Friday, October 31, 2008 6:47 pm
Subject: Re: Presumptive Antibiotic Administration And Chest Tube Insertion.
To: trauma-list at trauma.org

> There is NO good data on EITHER side of this  
> question.     It would take 20 
> years and somewhere close to  500,000 cases to reach some 
> sort of even crude 
> statistical power, because  empyema from an uncomplicated 
> tube thoracostomy is 
> so incrediably  low.     
> So.........over time there has been an agreement  
> that if one is to use any antibiotic at all, it should be one 
> that has minimal  
> complications.    My own recommendation is the 
> CHEAPEST oral  FIRST GENERATION 
> cephalosomething in your city's or hospital's  
> pharmacy.    NO, NO, NO, do not 
> sneak in a second generation  cephalosporin, or anything 
> any stronger.    It 
> simply in not  necessary.    
>  
> k
>  
>  
>  
>  
> In a message dated 10/31/2008 2:06:30 P.M. Central Daylight 
> Time,  
> Richard.Ferraro at chw.edu writes:
>  
> Rick  Ferraro Trauma Program Manager Mercy San Juan 
> Medical  Center
> 
> 
> 
> Question: I want to get feed back on your practice as it  
> pertains to one
> time antibiotic administration before chest tube insertion  
> for blunt or
> penetrating trauma. 
> 
> 
> 
> I hope this finds all  well!
> 
> 
> 
> 
> 
> --
> trauma-list : TRAUMA.ORG
> To change your  settings or unsubscribe  visit:
> http://www.trauma.org/index.php?/community/
> 
> 
> **************Plan your next getaway with AOL Travel.  
> Check out Today's Hot 
> 5 Travel Deals! 
> (http://pr.atwola.com/promoclk/100000075x1212416248x1200771803/aol?redir=http://travel.aol.com/discount-travel?ncid=emlcntustrav00000001)
> --
> trauma-list : TRAUMA.ORG
> To change your settings or unsubscribe visit:
> http://www.trauma.org/index.php?/community/

• Next message: Presumptive Antibiotic Administration And Chest Tube Insertion.
• Messages sorted by: [ date ] [ thread ] [ subject ] [ author ]