Guidelines and Key Points

## Antibiotics

Recommended for all open combat wounds

a. If able to take PO medications:

- Moxifloxacin, 400 mg PO once a day

b. If unable to take PO medications (shock, unconsciousness):

- Ertapenem, 1 g IV/IM once a day

#### Antibiotics Key Points

Moxifloxacin is broad spectrum and kills most bacteria. It has few side effects. Give as soon as possible after life-threatening conditions have been addressed. Delays in antibiotic administration increase the risk of wound infections.

- IM ertapenem should be diluted with lidocaine (1 gm vial ertapenem with 3.2cc lidocaine without epinephrine).

- IM- administer into a deep muscle mass (gluteal, lateral thigh).

- IM-use within 1 hour after preparation.

- IV requires a 30-minute infusion time.

The Combat Wound Medication Pack contains the following components:

- Moxifloxacin 400 mg one tablet (one),

- Meloxicam 15 mg one tablet (one),

- and Acetaminophen 1300 mg extended release, (2) 650 mg caplets.

These meds should be carried by EVERYONE in the unit and self-administered as soon as possible after sustaining a wound.

Screen your units for drug allergies!

Patients with allergies to aspirin or other non-steroidal anti-inflammatory drugs should not use Mobic.

Patients with allergies to fluoroquinolones, penicillins, or cephalosporins may need alternate antibiotics which should be selected by unit medical personnel during the pre-deployment phase.

Check with your unit physician if unsure.