Prophylactic antibiotics in abdominal and pelvic trauma

[Dimoak]

Has anyone had come across any definitive literature refuting or supporting the use of antibiotics in the trauma bay when it is suspected or confirmed that heavily floral structures have been compromised? It seems like it would make sense in order to lessen the possibility that lap/resx will uncover an overflowing cauldron of yuckness. At the same time, with the increasing prevalence of MRSA and other drug-resistant germs, it seems more and more centers are holding off on abx until sepsis is essentially staring them in the face. Either way, this seems like the type of issue where its mostly a difficult judgment call (especially when you factor in lawsuits from either directional outcomes). I was just wondering what everyone's views on the topic was.

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[dynx]

Has anyone had come across any definitive literature refuting or supporting the use of antibiotics in the trauma bay when it is suspected or confirmed that heavily floral structures have been compromised? It seems like it would make sense in order to lessen the possibility that lap/resx will uncover an overflowing cauldron of yuckness. At the same time, with the increasing prevalence of MRSA and other drug-resistant germs, it seems more and more centers are holding off on abx until sepsis is essentially staring them in the face. Either way, this seems like the type of issue where its mostly a difficult judgment call (especially when you factor in lawsuits from either directional outcomes). I was just wondering what everyone's views on the topic was.

http://www.east.org/tpg/atbpenetra.pdf
Here's some overview if its penetrating...We use cefotax and flagyl. For blunt and no indication for lap then no, I don't think so, but Im not sure I've ever seen a paper on it. I don't think it would make sense to use them since by not doing a ex-lap you're saying the person hasn't perfed anything.