Scientific Poster Session III - Residents and Fellows Research-in-Progress

Residents and Fellows Research in Progress
  Monday, October 14, 2024
  01:00 PM–02:30 PM

Abstract

Introduction: Infection is a significant concern for trauma patients, especially those with extensive tissue damage, such as open fractures, where risk can reach 52% due to environmental exposure and disrupted barriers. Despite guidelines recommending targeted antibiotic prophylaxis, our institution administers cefazolin to all trauma patients with fractures and penetrating injuries, regardless of severity.

Research Question or Hypothesis: This MUE aims to investigate the effectiveness of universal cefazolin trauma prophylaxis in preventing infections across various injuries.

Study Design: Retrospective MUE conducted at a level 1 trauma center.

Methods: Included adult patients with acute fractures or penetrating trauma who received cefazolin in the emergency department and were admitted to the surgical ICU between July 18, 2022, and July 18, 2024. Pregnant or incarcerated patients were excluded. The primary outcome was incidence of infection during hospitalization, defined as a provider-diagnosed infection or antibiotic administration coinciding with systemic signs or symptoms. Secondary endpoints included 30-day readmission and time to infection. Descriptive statistics were used, with normally distributed data presented as mean ± standard deviation and non-parametric data as median and interquartile range.

Results: A random sample of 100 patients was selected from 231 eligible cases, with 87 patients meeting criteria. The infection rate was 10.3% (n=9), with median onset of 9 days (4-10) and no 30-day readmissions. Among patients who developed infection during index hospitalization, MVCs and auto-pedestrian accidents were leading causes of trauma, each accounting for 33.3% of cases. Among patients who developed infections, closed fractures were present in 7 patients (77.8%) and open fractures in 6 (66.7%).

Conclusion: The universal use of cefazolin had an overall low rate of infection and no 30-day readmissions, suggesting potential effectiveness across various trauma injuries. Larger studies with more specific injury delineations are warranted.

Presenting Author

Lillian Weldon PharmD
Methodist Dallas Medical Center

Authors

Matthew Crotty PharmD
Methodist Dallas Medical Center

Christina Tran PharmD
Methodist Dallas Medical Center