Prophylactic Antibiotics for Penetrating Abdominal Trauma

This week, as part of the Child Health Emergency Medicine Social Media Campaign, we are highlighting a Cochrane summary on prophylactic antibiotics for penetrating abdominal trauma. This review was selected for the TREKK Evidence Repository on multiple trauma.

Key Messages:


Related TREKK Resources:

Cochrane Summary:

Should prophylactic antibiotics be used in patients with penetrating abdominal trauma?

For over half a century antibiotics have been given to patients that have suffered from a penetrating injury to the abdominal peritoneal cavity in an attempt to decrease the incidence of post-operative wound infection, intra-abdominal infection and mortality. This review was designed to assess whether or not this practice is supported by medical evidence.

No randomised controlled trials could be found that met the inclusion criteria for this review. Therefore, there is no evidence to unequivocally support or refute this practice. Current guidelines are based on expert opinion rather than fact.

We recommend that a randomised controlled trial be designed to assess which patients would benefit from antibiotic prophylaxis, and which patients would not. Hopefully this would result in less unnecessary antibiotic use, and thus less antibiotic resistance.

Authors’ conclusions:

There is currently no information from randomised controlled trials to support or refute the use of antibiotics for patients with penetrating abdominal trauma.

Check Out the Full Cochrane Systematic Review Below:

Brand, M., Grieve, A. (2013). Prophylactic antibiotics for penetrating abdominal trauma. Cochrane Database Syst Rev, 11, CD007370. doi:  10.1002/14651858.CD007370.pub3

Take Home Message:

High quality research is needed in this area so that evidence-based recommendations for treatment can be made. Check out the resources developed by TREKK for more information on what is currently known. Follow us @Cochrane_Child and @TREKKca for more on this topic throughout the week.


This post is part of a weekly blog series highlighting pediatric emergency medicine (PEM) focused Cochrane summaries and other key resources selected by TREKK.

Published by arrangement with John Wiley & Sons.