Gunshot or other trauma preventative antibiotics

[tmckay2]

You can get gram negative coverage by using a broader agent but in most cases it won't be necessary although it depends on whether you were infected from the object, from post contamination or from your own flora which was what I was covering for. Beta lantana and first gen cephalosporins won't cover everything but it will cover the most likely culprits. And yes iv would be preferred in gut wounds but obviously that isn't an option. Mrsa is a separate issue altogether but it is unlikely you will get it out in the back country, even if you yourself are a health care worker. Certainly I wouldn't argue that bactrim and doxy aren't good to have anyway but I just don't think it's likely you'll need it.

Moxi for trauma? That's bizarre. That's a respiratory FQ and generally is only reserved for respiratory infections.

For severe extremity injuries, i.e., open fractures of military/combat etiologies (not just routine civilian injuries), I'd prefer something with some gram-negative coverage as well. Cephalexin is ok, but no gram-neg coverage. Current recommendations would be something along the lines of cefuroxime, which has both gram-pos and gram-neg coverage. If concerned for MRSA, you'd need to add another agent, such as Bactrim or doxy, depending on local resistance patterns.

I agree that levofloxacin and metronidazole are fine for gut injuries, but certainly, IV would be a preferable route to oral, if at all possible.

[Fentonite]

You can get gram negative coverage by using a broader agent but in most cases it won't be necessary although it depends on whether you were infected from the object, from post contamination or from your own flora which was what I was covering for.

For most "civilian" wounds, I would agree with you. However, combat-related wounds have a higher incidence of soil and vegetation contaminants, and should be prophylaxed accordingly. Just my two cents.

[tmckay2]

For most "civilian" wounds, I would agree with you. However, combat-related wounds have a higher incidence of soil and vegetation contaminants, and should be prophylaxed accordingly (i.e., to cover aerobic gram-neg bacilli). Just my two cents.

True, vegetation could increase the chances on gram negative infections.