INFECTIOUS DISEASE

There is no role for prophylactic antibiotics in drowning victims either in freshwater or saltwater. Furthermore, rates of antimicrobial resistance in bacteria obtained from seawater drowning victims is negligible and broad-spectrum coverage is not indicated.

- Broad spectrum antibiotics to cover both gram-positive and gram-negative bacteria are indicated in patients where drowning occurs in a source with a high pathogen load (UFC >10).20
- Monitor patient for signs and symptoms of pneumonia (new pulmonary infiltrates on imaging, leukocytosis, fever, worsened respiratory status).
- Routine cultures are not required unless specific concern is present.
- Consider bronchoscopy for quantitative cultures or source control of possible aspirated nidus of infection.