prophylactic antibiotics for simple lacerations

[Adowns]

I am a recent grad and soon to be ED PA. I completed 2 seperate ED rotations during clinical yr of school. However I received contradicting information from the 2 rotations, regarding the use of prophylatic antibx for simple lacerations.

My question is, Is it standard practice or not to give a course of antibx for simple lacs. and if so, which antibx do you more commonly use?

[dreamin2baPA]

BestBets: Prophylactic antibiotics are not indicated in uncomplicated hand lacerations.

 

If it is a heavily contaminated lac, then I start with Keflex or try to match the coverage of flora from the contaminant. Usually, I cover for strep and staph. 5 days of Keflex.

 

Take a look at the link above to give you some insight on prophylactic abx. Also, don't forget that your number one defense against post closure infxn is copious irrigation through an 18-ga device.

 

Hope this helps

[EMEDPA]

agree with above. I only prophylax dirty wounds, older wounds, or immunocompromised pts(poorly controlled dm pt with lac on extremity for example.).