Adherence to published antimicrobial prophylaxis guidelines for wounded service members in the ongoing conflicts in Southwest Asia

Bradley A. Lloyd, Amy C. Weintrob, Mary K. Hinkle, Gerald R. Fortuna, Clinton K. Murray, William Bradley, Eugene V. Millar, Faraz Shaikh, Kristen Vanderzant, Stacie Gregg, Gina Lloyd, Julie Stevens, M. Leigh Carson, Deepak Aggarwal, David R. Tribble

Research output: Contribution to journalArticlepeer-review

Abstract

In 2008, a clinical practice guideline (CPG) was developed for the prevention of infections among military personnel with combat-related injuries. Our analysis expands on a prior 6-month evaluation and assesses CPG adherence with respect to antimicrobial prophylaxis for U.S. combat casualties medically evacuated to Landstuhl Regional Medical Center over a 1-year period (June 2009 through May 2010), with an eventual goal of continuously monitoring CPG adherence and measuring outcomes as a function of compliance. We classified adherence to the CPG as receipt of recommended antimicrobials within 48 hours of injury. A total of 1106 military personnel eligible for CPG assessment were identified and 74% received antimicrobial prophylaxis. Overall, CPG compliance within 48 hours of injury was 75%. Lack of antimicrobial prophylaxis contributed 2 to 22% to noncompliance varying by injury category, whereas receipt of antibiotics other than preferred was 11 to 30%. For extremity injuries, antimicrobial prophylaxis adherence was 60 to 83%, whereas it was 80% for closed injuries and 68% for penetrating abdominal injuries. Overall, the results of our analysis suggest an ongoing need to improve adherence, monitor CPG compliance, and assess effectiveness.

Original languageEnglish (US)
Pages (from-to)324-328
Number of pages5
JournalMilitary medicine
Volume179
Issue number3
DOIs
StatePublished - 2015

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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