Antimicrobial prescribing practices following publication of guidelines for the prevention of infections associated with combat-related injuries

David R. Tribble, Bradley Lloyd, Amy Weintrob, Anuradha Ganesan, Clinton K. Murray, Ping Li, William Bradley, Susan Fraser, Tyler Warkentien, Lakisha J. Gaskins, Françoise Seillier-Moiseiwitsch, Eugene V. Millar, Duane R. Hospenthal, Ken Wilkins, Barbara Nagaraj, Iksha Herr, Michael L. Landrum, Katrin Mende, James R. Dunne, Glenn W. Wortmann

Research output: Contribution to journalArticle

Abstract

Background: Timely and limited antibiotic prophylaxis (postinjury antimicrobial therapy) targeting specific traumatic injuries is a well-recognized measure to lessen posttraumatic infection. Modern military combat injuries raise significant challenges because of complex multiple injuries and limited data derived directly from well-controlled trials to base recommendations. Expert consensus review of available evidence led to published guidance for selection and duration of antimicrobial therapy for combat-related trauma infection prevention. This analysis evaluates antibiotic-prescribing practices by military physicians in the operational theater relative to the published guidance. Methods: Trauma history and infectious disease-specific inpatient care information is captured through the Joint Theater Trauma Registry along with a supplemental infectious disease module. Injury patterns are classified based on documented International Classification of Diseases-9th Revision codes with a composite assessment of each patient's injury pattern. Antimicrobial use categorized as prophylaxis is prescribed within the first 48 hours postinjury. Adherence to published guidance is reported along with patient characteristics and injury severity to assess for potential explanations of nonadherence. Results: During June to November 2009, 75% of the 610 eligible trauma patients received antimicrobial prophylaxis. Adherence to the recommended antibiotic agent on the day of injury was in the range of 46% to 50% for the most common extremity injury patterns and

Original languageEnglish (US)
JournalJournal of Trauma - Injury, Infection and Critical Care
Volume71
Issue number2 SUPPL. 2
DOIs
StatePublished - Aug 2011
Externally publishedYes

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Publications
Guidelines
Wounds and Injuries
Infection
Communicable Diseases
Anti-Bacterial Agents
Antibiotic Prophylaxis
Multiple Trauma
International Classification of Diseases
Registries
Inpatients
Extremities
Joints
Physicians
Therapeutics

Keywords

  • Adherence
  • Antimicrobial prophylaxis
  • Combat infections
  • Practice guidelines

ASJC Scopus subject areas

  • Surgery
  • Critical Care and Intensive Care Medicine

Cite this

Antimicrobial prescribing practices following publication of guidelines for the prevention of infections associated with combat-related injuries. / Tribble, David R.; Lloyd, Bradley; Weintrob, Amy; Ganesan, Anuradha; Murray, Clinton K.; Li, Ping; Bradley, William; Fraser, Susan; Warkentien, Tyler; Gaskins, Lakisha J.; Seillier-Moiseiwitsch, Françoise; Millar, Eugene V.; Hospenthal, Duane R.; Wilkins, Ken; Nagaraj, Barbara; Herr, Iksha; Landrum, Michael L.; Mende, Katrin; Dunne, James R.; Wortmann, Glenn W.

In: Journal of Trauma - Injury, Infection and Critical Care, Vol. 71, No. 2 SUPPL. 2, 08.2011.

Research output: Contribution to journalArticle

Tribble, DR, Lloyd, B, Weintrob, A, Ganesan, A, Murray, CK, Li, P, Bradley, W, Fraser, S, Warkentien, T, Gaskins, LJ, Seillier-Moiseiwitsch, F, Millar, EV, Hospenthal, DR, Wilkins, K, Nagaraj, B, Herr, I, Landrum, ML, Mende, K, Dunne, JR & Wortmann, GW 2011, 'Antimicrobial prescribing practices following publication of guidelines for the prevention of infections associated with combat-related injuries', Journal of Trauma - Injury, Infection and Critical Care, vol. 71, no. 2 SUPPL. 2. https://doi.org/10.1097/TA.0b013e318227af64
Tribble, David R. ; Lloyd, Bradley ; Weintrob, Amy ; Ganesan, Anuradha ; Murray, Clinton K. ; Li, Ping ; Bradley, William ; Fraser, Susan ; Warkentien, Tyler ; Gaskins, Lakisha J. ; Seillier-Moiseiwitsch, Françoise ; Millar, Eugene V. ; Hospenthal, Duane R. ; Wilkins, Ken ; Nagaraj, Barbara ; Herr, Iksha ; Landrum, Michael L. ; Mende, Katrin ; Dunne, James R. ; Wortmann, Glenn W. / Antimicrobial prescribing practices following publication of guidelines for the prevention of infections associated with combat-related injuries. In: Journal of Trauma - Injury, Infection and Critical Care. 2011 ; Vol. 71, No. 2 SUPPL. 2.
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