The efficacy of the use of presumptive antibiotics in tube thoracostomy in thoracic trauma-results of a meta-analysis.

Abstract

The purpose of this study was to determine the impact of presumptive antibiotics, used in chest traumas requiring thoracostomies, in preventing infections such as empyema and pneumonia. According to PRISMA guidelines, a systematic search of PubMed, Embase and Cochrane Library databases was conducted by two independent reviewers. Studies evaluating the role of antibiotics were included. Antibiotic administration was associated with a lower incidence of overall infectious complications (OR:0.6, 95%CI: 0.43 to 0.84, p = 0.003). Subgroup analysis revealing that the best protective effect against empyema (OR:0.35, 95%CI to 0.65, p = 0.001). When stratified by trauma type, antibiotic use was protective in penetrating injuries, against empyema (OR:0.14, 95%CI: 0.04 to 0.47, p = 0.001) and pneumonia (OR:0.24, 95%CI:, 0.12 to 0.53, p = 0.001) while there was no protective effect in blunt trauma against empyema (OR:0.25 95%CI: 0.03 to 1.73, p = 0.16) or pneumonia (OR:1.22, 95%CI: 0.38 3.90, p = 0.72). Presumptive antibiotic use in thoracostomies has a clear role in preventing infectious complications in trauma patients. This role is primarily attributed to their protective effect on penetrating trauma patients.

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