SUMMARY OF CHANGES
- New references have been added based on new data from the Trauma Infectious Disease Outcomes Study supporting previous recommendations to limit gram negative therapy for prophylaxis of extremity wounds.
- The duration of antibiotics for open fractures has been curtailed to only the first 24 hours and re-dosing with subsequent irrigation and debridement.
- Clarification had been added to describe the cohorting of patients. Long term patients (>72 hours) had been clarified to mean host nation patients; short term (<72 hours) has been clarified to mean U.S. personnel.
- Antimicrobial stewardship recommendations have been expanded to include the recommendation for facilities responsible for trauma care to monitor adherence to antimicrobial prophylaxis regimens.
- Reach back information has been updated to include the ADvanced VIrtual Support for OpeRational forces (AD.VI.S.OR) network and to the updated Army Infection Control email address.
- Vancomycin dosing has been updated to reflect weight-based dosing and clindamycin dosing has been simplified.
- A tetanus prophylaxis appendix has been added.