One hundred and sixty-two patients were studied in a random double-blind controlled trial of co-trimoxazole to prevent secondary haemorrhage following transurethral resection of the prostate (TURP). There was a significant correlation between the incidence of post-operative urinary infection and secondary haemorrhage (P less than 0.05) but no difference between the incidence of bleeding in the treatment and placebo groups. Although infection may play a role in the development of secondary haemorrhage, co-trimoxazole for 10 days does not decrease the incidence of this complication.
Antibiotic administration at the time of wound manipulation has not been shown to decrease infection rates for simple traumatic wounds. Antibiotic administration at the time of initial emergency department (ED) presentation, however, has not been explored. Patients presenting to the ED with simple traumatic wounds received 1 g of oral flucloxacillin, or identical placebo, at triage. Wound closure was completed at the discretion of a physician blinded to study contents. Wound infection rates were determined at 1 month. Time from drug administration to wound manipulation was 64.3 min [95% confidence interval (CI) 36.6-91.9] placebo versus 75.0 min (95% CI: 51.7-98.3) flucloxacillin, P=0.657. Six of 36 patients (17%) reported wound infection in the placebo group, and four of 34 (12%) in the flucloxacillin group, P=0.736. Administration of oral flucloxacillin at triage failed to reduce the rate of wound infection for simple traumatic wounds closed in the ED.
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