Discharge Medications for Trauma Patients
Author- Nicholas Carter
Apporoved- Nicholas Namias October 2025
Outpatient Venous Thromboembolism Chemoprophylaxis:
Patients with orthopedic injuries including fractures of pelvis/hip/femur/tibia/fibula should be discharged with a prescription for 4 weeks of outpatient VTE chemoprophylaxis unless specifically excluded by a trauma attending.
- Orthopedic injuries listed above WITHOUT traumatic brain injury: ASA 81mg BID x 4 weeks
- Orthopedic injuries listed above WITH traumatic brain injury: Enoxaparin 30mg BID x 4 weeks
Outpatient Antibiotics:
In general, patients should not be discharged with oral antibiotics for fractures or soft tissue injuries due to limited benefit, risk of clostridium difficile infection, and development of resistance. Any recommendation for outpatient antibiotics must be discussed with the trauma attending prior to prescribing.
Outpatient Levetiracetam (Keppra)
Please prescribe oral levetiracetam at discharge to complete the intended duration of therapy.
- Patients with traumatic brain injury without seizures should usually complete a total course of 7 days of levetiracetam. The typical dose is 1000mg BID for adults and 500mg BID for geriatric patients.
- For patients with TBI who experience seizures, please ensure that outpatient anti-epileptic prescriptions match consulting service recommendations for outpatient agent and duration.
Outpatient Venous Thromboembolism Chemoprophylaxis:
Patients with orthopedic injuries including fractures of pelvis/hip/femur/tibia/fibula should be discharged with a prescription for 4 weeks of outpatient VTE chemoprophylaxis unless specifically excluded by a trauma attending.
- Orthopedic injuries listed above WITHOUT traumatic brain injury: ASA 81mg BID x 4 weeks
- Orthopedic injuries listed above WITH traumatic brain injury: Enoxaparin 30mg BID x 4 weeks
Outpatient Antibiotics:
In general, patients should not be discharged with oral antibiotics for fractures or soft tissue injuries due to limited benefit, risk of clostridium difficile infection, and development of resistance. Any recommendation for outpatient antibiotics must be discussed with the trauma attending prior to prescribing.
Outpatient Levetiracetam (Keppra)
Please prescribe oral levetiracetam at discharge to complete the intended duration of therapy.
- Patients with traumatic brain injury without seizures should usually complete a total course of 7 days of levetiracetam. The typical dose is 1000mg BID for adults and 500mg BID for geriatric patients.
- For patients with TBI who experience seizures, please ensure that outpatient anti-epileptic prescriptions match consulting service recommendations for outpatient agent and duration.