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Antibiotic prophylaxis at triage for simple traumatic wounds: a pilot study

Cowell, David Lorda; Harvey, Martyna; Cave, Grantb,c

European Journal of Emergency Medicine: October 2011 - Volume 18 - Issue 5 - p 279–281
doi: 10.1097/MEJ.0b013e3283456807

Antibiotic administration at the time of wound manipulation has not been shown to decrease infection rates for simple traumatic wounds. Antibiotic administration at the time of initial emergency department (ED) presentation, however, has not been explored. Patients presenting to the ED with simple traumatic wounds received 1 g of oral flucloxacillin, or identical placebo, at triage. Wound closure was completed at the discretion of a physician blinded to study contents. Wound infection rates were determined at 1 month. Time from drug administration to wound manipulation was 64.3 min [95% confidence interval (CI) 36.6–91.9] placebo versus 75.0 min (95% CI: 51.7–98.3) flucloxacillin, P=0.657. Six of 36 patients (17%) reported wound infection in the placebo group, and four of 34 (12%) in the flucloxacillin group, P=0.736. Administration of oral flucloxacillin at triage failed to reduce the rate of wound infection for simple traumatic wounds closed in the ED.

aDepartment of Emergency Medicine, Waikato Hospital, Hamilton

bUniversity of Otago, Wellington School of Medicine and Health Sciences, Wellington, New Zealand

cHutt Hospital and Tamworth Rural Referral Hospital, New South Wales, Australia

Correspondence to Dr Martyn Harvey, BHB, MBChB, FACEM, Department of Emergency Medicine, Waikato Hospital, Pembroke Street, Hamilton, New Zealand Tel: +61 7 838 8899; fax: +64 7 839 8772; e-mail:

Received September 9, 2010

Accepted February 4, 2011

© 2011 Lippincott Williams & Wilkins, Inc.