PURPOSE: A
task force appointed by the Korean Society of
Acute Care Surgery reviewed previously published guidelines on
antibiotic use in
patients with
abdominal injuries and adapted guidelines for
Korea .
METHODS: Four guidelines were assessed using the Appraisal of Guidelines for
Research and Evaluation II instrument. Five topics were considered indication for
antibiotics ,
time until first
antibiotic use,
antibiotic therapy duration , appropriate
antibiotics , and
antibiotic use in abdominal
trauma patients with
hemorrhagic shock .
RESULTS: Patients requiring
surgery need preoperative prophylactic
antibiotics .
Patients who do not require
surgery do not need
antibiotics .
Antibiotics should be administered as soon as possible after
injury . In the absence of hollow viscus
injury , no additional
antibiotic doses are needed. If hollow viscus
injury is repaired within 12 hours,
antibiotics should be continued for ≤ 24 hours. If hollow viscus
injury is repaired after 12 hours,
antibiotics should be limited to 7 days.
Antibiotics can be administered for ≥7 days if hollow viscus
injury is incompletely repaired or clinical signs persist. Broad-spectrum aerobic and anaerobic coverage
antibiotics are preferred as the initial
antibiotics .
Second-generation cephalosporins are the recommended initial
antibiotics . Third-generation
cephalosporins are alternative choices. For
hemorrhagic shock , the
antibiotic dose may be increased twofold or threefold and repeated after transfusion of every 10 units of
blood until there is no further
blood loss.
CONCLUSION: Although this
guideline was drafted through adaptation of other guidelines, it may be meaningful in that it provides a
consensus on the use of
antibiotics in abdominal
trauma patients in
Korea .