Highlights
- •Prehospital cefazolin was not associated with anaphylactic reactions.
- •The inappropriate administration rate for prehospital cefazolin was low.
- •The overall open fracture and deep wound infection rate after prehospital cefazolin was 6%.
Abstract
Objective
A lack of research has become a barrier to the common use of prehospital antibiotics.
The objective of this study is to further the limited research of prehospital antibiotics
through evaluating the clinical impact, safety, and reliability of prehospital cefazolin
administration in trauma patients.
Methods
We completed a retrospective evaluation of adult trauma patients who were transported
by a single air and ground critical care transport program between January 1, 2014,
and June 30 2017. Two hundred eighty-two patients received prehospital cefazolin for
deep wounds or open fractures before their arrival at a single level 2 trauma center
during the study period. Patient demographics, mechanism of injury, injury type, infection
rate, and identification of allergic reactions to cefazolin were also collected.
Results
Of 278 patients in the final analysis, 35.3% (n = 98) were diagnosed with an open
fracture and 58.6% (n = 163) had a deep tissue injury. Eighty-two percent of prehospital
open fracture diagnoses were confirmed in the emergency department. The overall infection
rate was 6%; 31.3% of patients received a second dose of cefazolin in the emergency
department during the study period. No patients receiving prehospital cefazolin had
allergic or anaphylactic reactions. The overadministration rate was 5% (n = 14).
Conclusion
Prehospital providers reliably identified open fractures, and prehospital cefazolin
administration was not associated with anaphylactic reactions. This study population's
infection rate of open fractures caused by traumatic injury was found to be 6%, and
there was a low inappropriate administration rate.
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Article Info
Publication History
Published online: July 08, 2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2022 Air Medical Journal Associates. Published by Elsevier Inc. All rights reserved.
