Updated Protocol for Prescribing Antibiotics to War Wounded

The administration of systemic antibiotics prophylactically in combat causaulties is an issue of much controversy. Despite lack of sound scientific evidence, the current trend in military medicine recommends prophylactic antibiotic administration. Cleansing and debridement of all devitalized tissues and foreign bodies is crucial, otherwise, antibiotic prophylaxis will be ineffective. Irrigation with clean drinking water, or sterile isotonic solutions, at the earliest opportunity, and in the first possible place after the trauma, is at the heart of the prevention of infection in the wounded, and is sufficient for many simple wounds. Administration of systemic prophylactic antibiotics is essential in cases where wounds are deep or complex, in open fractures, as well as in other complicated situations in patients with simple wounds managed by sufficient irrigation and debridment but a quick return to service is mandatory, administration of prophylactic antibiotics is allowed (1).