PMID- 23723281
OWN - NLM
STAT- MEDLINE
DCOM- 20130730
LR  - 20160525
IS  - 2049-4408 (Electronic)
IS  - 2049-4394 (Linking)
VI  - 95-B
IP  - 6
DP  - 2013 Jun
TI  - Short duration of antibiotic prophylaxis in open fractures does not enhance risk 
      of subsequent infection.
PG  - 831-7
LID - 10.1302/0301-620X.95B6.30114 [doi]
AB  - 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.
FAU - Dunkel, N
AU  - Dunkel N
AD  - Geneva University Hospitals, 4 rue Gabrielle Perret-Gentil, 1211 Geneva, 
      Switzerland.
FAU - Pittet, D
AU  - Pittet D
FAU - Tovmirzaeva, L
AU  - Tovmirzaeva L
FAU - Suva, D
AU  - Suva D
FAU - Bernard, L
AU  - Bernard L
FAU - Lew, D
AU  - Lew D
FAU - Hoffmeyer, P
AU  - Hoffmeyer P
FAU - Uckay, I
AU  - Uckay I
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Bone Joint J
JT  - The bone & joint journal
JID - 101599229
RN  - 0 (Anti-Bacterial Agents)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Anti-Bacterial Agents/*therapeutic use
MH  - Antibiotic Prophylaxis/*methods
MH  - Female
MH  - Follow-Up Studies
MH  - Fractures, Open/*complications
MH  - Humans
MH  - Incidence
MH  - Male
MH  - Middle Aged
MH  - Odds Ratio
MH  - Retrospective Studies
MH  - Switzerland/epidemiology
MH  - Time Factors
MH  - Wound Infection/epidemiology/*prevention & control
MH  - Young Adult
OTO - NOTNLM
OT  - Antibiotic
OT  - Complications
OT  - Duration
OT  - Infection
OT  - Open fractures
OT  - Prophylaxis
EDAT- 2013/06/01 06:00
MHDA- 2013/07/31 06:00
CRDT- 2013/06/01 06:00
PHST- 2013/06/01 06:00 [entrez]
PHST- 2013/06/01 06:00 [pubmed]
PHST- 2013/07/31 06:00 [medline]
AID - 95-B/6/831 [pii]
AID - 10.1302/0301-620X.95B6.30114 [doi]
PST - ppublish
SO  - Bone Joint J. 2013 Jun;95-B(6):831-7. doi: 10.1302/0301-620X.95B6.30114.