Antibiotic Prophylaxis for Simple Traumatic Wounds in the Emergency Department: A Cross-Sectional Study in Abadan and Khorramshahr, Iran

Abstract

Background: The administration of prophylactic antibiotics for traumatic injuries continues to be a subject of debate. Despite heightened examination of their application in infection prevention, this practice remains prevalent. Objectives: This study examined the rate and patterns of antibiotic prescription for simple traumatic wounds in emergency departments (EDs) of hospitals in Abadan and Khorramshahr, Iran, from 2020 to 2021. Methods: This retrospective cross-sectional study analyzed records of 400 outpatients with simple traumatic wounds treated in EDs of two hospitals (March 2020 - March 2021). Patients with complex wounds or comorbidities (e.g., immunodeficiency, diabetes) were excluded. Data on demographics, wound characteristics, and antibiotic prescriptions were extracted and analyzed using SPSS version 21.0 with descriptive and inferential statistics (significance: P < 0.05). Results: Participants were predominantly male (81%). Lacerations were the most common wound type (85%), with extremities (hands and feet) the primary location (52.5%). Prophylactic antibiotics were prescribed in 98.5% of cases, predominantly cephalexin (92.2%) as monotherapy (87%). Significant associations existed between prescriptions and male gender (P = 0.018), extremity location (P < 0.001), and visible contamination (P = 0.003). Conclusions: Antibiotic prophylaxis for simple traumatic wounds was nearly universal, diverging markedly from evidence-based guidelines favoring selective use. This underscores the need for antimicrobial stewardship, local guidelines, and prospective studies to evaluate infection outcomes and optimize prescribing. This study is limited by its retrospective design, reliance on record accuracy, and absence of follow-up data on infection outcomes, which may affect generalizability.