Inflammation and the host response to injury, a large-scale collaborative project: @entity1 -oriented research core--standard operating procedures for clinical care VII--Guidelines for antibiotic administration in severely injured XXXX .

@entity1 @entity39 @entity3124 @entity281 @entity358 @entity922
When the clinical decision to treat a @entity3124 patient with antibiotics has been made, one must attempt to identify the site of @entity281 based on clinical signs and symptoms, laboratory or diagnostic radiology studies. Identification of site requires, examination of @entity1 , inspection of all wounds, chest radiograph, and calculation of clinical @entity358 score if ventilated, obtaining blood cultures, urinalysis, and line change if clinical suspicion of central venous catheter (CVC) source. If it is impossible to identify site, obtain cultures from all accessible suspected sites and initiate empiric, broad spectrum antibiotics. If likely site can be identified answer these questions: Is intra-abdominal site suspected? Is pulmonary source of @entity281 suspected? Is skin, skin structure or soft tissue site suspected? If yes, does the @entity1 have clinical signs suspicion for @entity39 soft tissue @entity281 (NSTI)? Is a CVC @entity281 suspected? Risk factors for more complicated @entity281 are discussed and specific antibiotic recommendations are provided for each type and severity of @entity922 . Decision to continue, discontinue and/or alter antibiotic/antimicrobial treatment should be based on the clinical response to treatment, diagnostic or interventional findings, and culture and sensitivity data, bearing in mind that not all @entity1 with @entity281 will have positive cultures because of limitations of specimen handling, microbiology laboratory variations, time between specimen acquisition and culture, or presence of effective antibiotics at the time that specimens were obtained. It should also be noted that not all @entity1 with increased temperature/WBC have an @entity281 . Discontinuation of antibiotics is appropriate if cultures and other diagnostic studies are negative.
