Prophylactic administration of
antibiotics is prevalent for traumatic patients including
head injury, when the patients have contaminated
wounds, CSF leakage, and
multiple injuries. In cases with prolonged
fever and inflammatory signs, other
antibiotics must be selected without confirming the
infections by cultures. Usually, 1st or 2nd generation cefalosporins are selected as empiric
therapy for traumatic patients, but, successive
antibiotics are usually selected according to the situation. In this study, we analyzed 60 cases of head injured patients with Glasgow Coma Scale under 12, in terms of the selection of
antibiotics and the reasons for the
antibiotic selections. CEZ > PIPC > FMOX were used for initial treatment without any culture results. The second selection was made without any positive culture results in 85.7%, and tertiary selection without culture results in 50% of the patients.
CPR > CFSL > FMOX >
PAPM/BP were mainly used as second selection, and IPM/CS >
CPR = PIPC were mainly used as tertiary selection. In cases with
traumatic brain injuries, it is important to prevent
antibiotic resistances. 1) by selecting appropriate
antibiotics, 2) by using
antibiotics after excluding
catheter related infections, 3) by not using
antibiotics and performing frequent cultures when no apparent
infection focuses are detected.