Comparing the effectiveness of oral versus intravenous antibiotics in the prophylaxis of wound infection in hand laceration

Abstract

Objective: Hand lacerations are among the most frequent causes of visiting emergency departments (EDs). Wound infection is one of its complications. There is still an ongoing disagreement on the administration of oral versus intravenous (IV) antibiotics (ABs). The objective of this study is to compare the effectiveness of oral versus IV ABs in preventing wound infection of hand lacerations. Methods: In this double-blind, randomized clinical trial, we enrolled all patients with hand lacerations (based on the inclusion criteria) during 6 months in the EDs of 2 tertiary referral centers. Convenient sampling was done. Finally, in the first group, 382 patients received oral AB (two 500 mg cephalexin capsules) and the other 382 patients in the second group received IV AB (1 gr IV cefazolin) before wound management. Both groups were followed and received oral cephalexin during 48 hours after suturing. Rates of wound infection and different complications were compared between the two groups. T-test, Mann-Whitney U test, Chi square and Fisher analysis were used. Results: Both groups had the same age and gender distribution rate (79.8% of males with the mean age of 30.8 years in the first group, and 83.5% of males with the mean age of 32.6 years in the second group (P=0.19 and 0.39, respectively). In our study, wound infection developed in 2.6% and 1.8% of patients in the first and second groups, respectively (P=0.46). Conclusion: Based on the results of this study, oral and IV ABs were not significantly different in terms of preventing wound infection.