June 10, 2013

Guideline Title

Presumptive antibiotic use in tube thoracostomy for traumatic hemopneumothorax: an Eastern Association for the Surgery of Trauma practice management guideline.

Bibliographic Source(s)

Moore FO, Duane TM, Hu CK, Fox AD, McQuay N Jr, Lieber ML, Como JJ, Haut ER, Kerwin AJ, Guillamondegui OD, Burns JB, Eastern Association for the Surgery of Trauma. Presumptive antibiotic use in tube thoracostomy for traumatic hemopneumothorax: an Eastern Association for the Surgery of Trauma practice management guideline. J Trauma Acute Care Surg. 2012 Nov;73(5 Suppl 4):S341-4. [20 references] PubMed External Web Site Policy

Guideline Status

This is the current release of the guideline.
This guideline updates a previous version:
Luchette FA, Barrie PS, Oswanski MF, Spain DA, Mullins CD, Palumbo F, Pasquale MD. Practice management guidelines for prophylactic antibiotic use in tube thoracostomy for traumatic hemopneumothorax. J Trauma 2000 Apr;48(4):753-7. [26 references]
Practice management guidelines for prophylactic antibiotic use in tube thoracostomy for traumatic hemopneumothorax. Allentown (PA): Eastern Association for the Surgery of Trauma (EAST); 2000. 16 p. [26 references]

Presumptive antibiotic use in tube ... [J Trauma Acute Care Surg. 2012] - PubMed - NCBI

2012 Nov;73(5 Suppl 4):S341-4. doi: 10.1097/TA.0b013e31827018c7.

Presumptive antibiotic use in tube thoracostomy for traumatic hemopneumothorax: an Eastern Association for the Surgery of Trauma practice management guideline.

Moore FO, Duane TM, Hu CK, Fox AD, McQuay N Jr, Lieber ML, Como JJ, Haut ER, Kerwin AJ, Guillamondegui OD, Burns JB; Eastern Association for the Surgery of Trauma.

Source

Division of Trauma and Surgical Critical Care, Louisiana State University Health Sciences Center, Shreveport, Louisiana 71130, USA. moore677@aol.com

Abstract

BACKGROUND:

Antibiotic use in injured patients requiring tube thoracostomy (TT) to reduce the incidence of empyema and pneumonia remains a controversial practice. In 1998, the Eastern Association for the Surgery of Trauma (EAST) developed and published practice management guidelines for the use of presumptive antibiotics in TT for patients who sustained a traumatic hemopneumothorax. The Practice Management Guidelines Committee of EAST has updated the 1998 guidelines to reflect current literature and practice.

METHODS:

A systematic literature review was performed to include prospective and retrospective studies from 1997 to 2011, excluding those studies published in the previous guideline. Case reports, letters to the editor, and review articles were excluded. Ten acute care surgeons and one statistician/epidemiologist reviewed the articles under consideration, and the EAST primer was used to grade the evidence.

RESULTS:

Of the 98 articles identified, seven were selected as meeting criteria for review. Two questions regarding presumptive antibiotic use in TT for traumatic hemopneumothorax were addressed: (1) Do presumptive antibiotics reduce the incidence of empyema or pneumonia? And if true, (2) What is the optimal duration of antibiotic prophylaxis?

CONCLUSION:

Routine presumptive antibiotic use to reduce the incidence of empyema and pneumonia in TT for traumatic hemopneumothorax is controversial; however, there is insufficient published evidence to support any recommendation either for or against this practice.