{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T22:39:00Z","timestamp":1788388740674,"version":"build-2803163510"},"reference-count":38,"publisher":"Oxford University Press (OUP)","issue":"3-4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,2,27]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Current Tactical Combat Casualty Care (TCCC) guidelines recommend antibiotic administration for all open wounds to prevent infection. We identified associations between demographics, procedures, and medicines with the receipt of prehospital antibiotics among combat casualties.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Materials and Methods<\/jats:title>\n                  <jats:p>We used a series of emergency department procedure codes to identify adult subjects within the Department of Defense Trauma Registry from January 2007 to August 2016 who sustained open wounds. We compared demographics, procedures, and medicines administered among casualties receiving prehospital wound prophylaxis versus casualties not receiving antibiotic prophylaxis. We controlled for confounders with multivariable logistical regression.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>We identified 18,366 encounters meeting inclusion criteria. Antibiotic recipients (n\u2009=\u20092384) were comparable to nonrecipients (n\u2009=\u200915,982) with regard to age and sex. Antibiotic recipients were more likely to sustain injuries from firearms and undergo all procedures examined related to hemorrhage control, airway management, pneumothorax treatment, and volume replacement except for intraosseous access. Antibiotic recipients were less likely to sustain injuries from explosives. Antibiotic recipients had a modestly higher survival than nonrecipients (97.4% versus 96.0%). Associations with prehospital antibiotic receipt in multivariable logistic regression included non-North Atlantic Treaty Organization military force affiliation (odds ratio (OR) 4.65, 95% CI, 1.0-20.8), tachycardia (OR 3.4, 95% CI, 1.1-10.5), intubation (OR 2.0, 95% CI, 1.1-3.8), and administration of tranexamic acid (OR 5.6, 95% CI, 1.2-26.5).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The proportion of combat casualties with open wounds receiving prehospital antibiotics was low despite published recommendations for early antibiotics in patients with open wounds. These findings highlight the ongoing need for additional educational and quality assurance initiatives to continue improving adherence to TCCC guidelines with regard to prehospital antibiotic administration. Future studies are necessary to determine reasons for suboptimal TCCC guideline compliance.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/milmed\/usad323","type":"journal-article","created":{"date-parts":[[2023,8,30]],"date-time":"2023-08-30T20:54:50Z","timestamp":1693428890000},"page":"e606-e611","source":"Crossref","is-referenced-by-count":3,"title":["Associations with Prehospital Antibiotic Receipt among Combat Casualties with Open Wounds: A Department of\u00a0Defense Trauma Registry Study"],"prefix":"10.1093","volume":"189","author":[{"given":"Marissa C","family":"Karp","sequence":"first","affiliation":[{"name":"Adjutant General Captains Career Course , Fort Jackson, SC 29207, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael D","family":"April","sequence":"additional","affiliation":[{"name":"14th Field Hospital , Fort Stewart, GA, USA"},{"name":"Department of Military and Emergency Medicine, Uniformed Services University of the Health Sciences , Bethesda, MD 20814, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan K","family":"Newberry","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, University of Wisconsin School of Medicine and Public Health , Madison, WI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2322-5216","authenticated-orcid":false,"given":"Steven G","family":"Schauer","sequence":"additional","affiliation":[{"name":"Department of Military and Emergency Medicine, Uniformed Services University of the Health Sciences , Bethesda, MD 20814, USA"},{"name":"Departments of Anesthesiology and Emergency Medicine, University of Colorado School of Medicine , Aurora, Colorado 80045, USA"},{"name":"Center for Combat and Battlefield (COMBAT) Research, University of Colorado School of Medicine , Aurora, Colorado 80045, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,8,30]]},"reference":[{"key":"2024022722271229900_R1","first-page":"3","article-title":"A descriptive analysis of\u00a0notional casualties sustained at the joint readiness training center: implications for\u00a0health service support during large-scale combat operations","author":"April","year":"2021","journal-title":"Med J (Ft Sam Houst Tex)"},{"issue":"1","key":"2024022722271229900_R2","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1001\/jamasurg.2015.3104","article-title":"The effect of\u00a0a golden hour policy on\u00a0the morbidity and\u00a0mortality of\u00a0combat casualties","volume":"151","author":"Kotwal","year":"2016","journal-title":"JAMA Surg"},{"key":"2024022722271229900_R3","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000005787","article-title":"The golden hour of\u00a0casualty care: rapid handoff to surgical team is associated with improved survival in\u00a0war-injured US service members","author":"Shackelford","year":"2023","journal-title":"Ann Surg"},{"issue":"2S","key":"2024022722271229900_R4","doi-asserted-by":"publisher","first-page":"S135","DOI":"10.1016\/j.wem.2017.02.001","article-title":"Prolonged field care: beyond the \u201cGolden Hour\u201d","volume":"28","author":"Keenan","year":"2017","journal-title":"Wilderness Environ Med"},{"issue":"4","key":"2024022722271229900_R5","doi-asserted-by":"publisher","DOI":"10.55460\/BG09-1JE2","article-title":"Deconstructing the definition of\u00a0prolonged field care","volume":"15","author":"Keenan","year":"2015","journal-title":"J Spec Oper Med"},{"issue":"Suppl 2","key":"2024022722271229900_R6","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1093\/milmed\/usz027","article-title":"After the battlefield: infectious complications among wounded warriors in\u00a0the trauma infectious disease outcomes study","volume":"184","author":"Tribble","year":"2019","journal-title":"Mil Med"},{"key":"2024022722271229900_R7","first-page":"21","article-title":"Pre-hospital systemic antibiotic prophylaxis for\u00a0penetrating trauma: is the military usage applicable to civil emergency medical services? 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