Fishhook Injuries and Antibiotic Prescribing Patterns: A Retrospective Analysis.

Abstract

Introduction: Fishhook injuries are a common occurrence among anglers. There are no guidelines for prophylactic antibiotic use after fishhook removal. This study analyzed the management of embedded fishhooks, prophylactic antibiotic use, and complication rate at a Michigan county emergency department to observe whether antibiotic use changes patient outcome. Commentary on a freshwater pathogen (Aeromonas hydrophila) is also included.

Methods: Cases were obtained through a retrospective chart review of patients seen for fishhook injury between 2016 and 2022. We analyzed age, sex, relevant medical history, type of fishhook, site preparation, removal technique, antibiotic use, return visit within 30 days, and complications.

Results: Fifty-one patients with fishhooks injuries were identified. Mean age was 48±17 y. Forty-three patients were male (84%), and 8 were female (16%). Hook site varied, with most occurring in the finger/thumb (78.4%) and scalp (5.9%). One case involved the ear cartilage. The most common removal technique was the advance and cut method (52.9%). Four patients had an immunocompromising condition (eg, diabetes). Oral antibiotics were prescribed to 26 patients (51%) on discharge. Prophylactic antibiotic choice varied-cephalexin predominated (61.5%). There were no wound infections or complications in cases where the fishhook was removed during the emergency department encounter (50 of 51). One case involved a delayed presentation, abscess formation, and outpatient hand surgery referral.

Conclusions: In this small observational study, antibiotic prophylaxis for freshwater-associated fishhook injury did not change outcome regardless of fishhook location or presence of an immunocompromising condition. Further controlled studies are needed to determine the validity of these findings.