Use of prophylactic antibiotics following tube thoracostomy for blunt chest trauma in the prevention of empyema and pneumonia

hest injury is a common problem in patients sustaining blunt or penetrating trauma.1 Thoracic wounds account for 20-25% of all trauma deaths. Only 10-15% of all chest wounds require tube thoracostomy, whereas the remaining 85% can be managed with a closed tube thoracostomy.2 A major morbidity associated with this therapeutic device is empyema. The role of prophylactic antibiotics in reducing the incidence of this complication is controversial. Multiple factors contribute to the development of posttraumatic empyema. These factors include the conditions under which the tube is inserted (emergent or urgent), the mechanism of injury, retained hemothorax and ventilator care.38 The primary goal of prophylactic antibiotic use in injured patients requiring tube thoracostomy is to reduce the incidence of empyema and its associated morbidity. The primary benefit must be significant because of the risk of the emergence of resistant organisms with excessive use of antimicrobials. In addition, cost is a major concern in the current health care market. The abovementioned concerns were the reasons for performing this study.