UNIGE document Scientific Article
previous document  unige:29954  next document
add to browser collection

Short duration of antibiotic prophylaxis in open fractures does not enhance risk of subsequent infection

Tovmirzaeva, L
Published in The bone & joint journal. 2013, vol. 95-B, no. 6, p. 831-7
Abstract We undertook a retrospective case-control study to assess the clinical variables associated with infections in open fractures. A total of 1492 open fractures were retrieved; these were Gustilo and Anderson grade I in 663 (44.4%), grade II in 370 (24.8%), grade III in 310 (20.8%) and unclassifiable in 149 (10.0%). The median duration of prophylaxis was three days (interquartile range (IQR) 1 to 3), and the median number of surgical interventions was two (1 to 9). We identified 54 infections (3.6%) occurring at a median of ten days (IQR 5 to 20) after trauma. Pathogens intrinsically resistant to the empirical antibiotic regimen used (enterococci, Enterobacter spp, Pseudomonas spp) were documented in 35 of 49 cases (71%). In multivariable regression analyses, grade III fractures and vascular injury or compartment syndrome were significantly associated with infection. Overall, compared with one day of antibiotic treatment, two to three days (odds ratio (OR) 0.6 (95% confidence interval (CI) 0.2 to 2.0)), four to five days (OR 1.2 (95% CI 0.3 to 4.9)), or > five days (OR 1.4 (95% CI 0.4 to 4.4)) did not show any significant differences in the infection risk. These results were similar when multivariable analysis was performed for grade III fractures only (OR 0.3 (95% CI 0.1 to 3.4); OR 0.6 (95% CI 0.2 to 2.1); and OR 1.7 (95% CI 0.5 to 6.2), respectively). Infection in open fractures is related to the extent of tissue damage but not to the duration of prophylactic antibiotic therapy. Even for grade III fractures, a one-day course of prophylactic antibiotics might be as effective as prolonged prophylaxis.
Keywords AdolescentAdultAgedAged, 80 and overAnti-Bacterial Agents/therapeutic useAntibiotic Prophylaxis/methodsFemaleFollow-Up StudiesFractures, Open/complicationsHumansIncidenceMaleMiddle AgedOdds RatioRetrospective StudiesSwitzerland/epidemiologyTime FactorsWound Infection/epidemiology/prevention & controlYoung Adult
PMID: 23723281
Full text
Article (Published version) (259 Kb) - document accessible for UNIGE members only Limited access to UNIGE
Research groups Chirurgie orthopédique et traumatologique (98)
Glycopeptide résistance (28)
Staphylocoques dorés résistants à la méthicilline et hygiène hospitalière (330)
(ISO format)
DUNKEL, Nathalie et al. Short duration of antibiotic prophylaxis in open fractures does not enhance risk of subsequent infection. In: The bone & joint journal, 2013, vol. 95-B, n° 6, p. 831-7. doi: 10.1302/0301-620X.95B6.30114 https://archive-ouverte.unige.ch/unige:29954

476 hits

0 download


Deposited on : 2013-09-26

Export document
Format :
Citation style :