PMID- 31381489
OWN - NLM
STAT- MEDLINE
DCOM- 20201120
LR  - 20201120
IS  - 1557-8674 (Electronic)
IS  - 1096-2964 (Linking)
VI  - 21
IP  - 1
DP  - 2020 Feb
TI  - Piperacillin/Tazobactam versus Tobramycin-Based Antibiotic Prophylaxis for Type 
      III Open Fractures.
PG  - 23-28
LID - 10.1089/sur.2019.064 [doi]
AB  - Background: Type III open fractures are associated with an infection rate as high 
      as 50%. The optimal antibiotic for open fracture prophylaxis remains unclear, and 
      the literature comparing the safety and efficacy of different antibiotic regimens 
      is limited. The aim of this study was to compare the composite adverse events 
      (AEs) in patients before and after a change in prophylactic antibiotic management 
      for these injuries from a tobramycin- to a piperacillin/tazobactam-based regimen. 
      Methods: This was a retrospective single-center cohort study of patients with 
      Type III open fractures admitted from January 2010 to December 2016. Patients 
      were included if they received either tobramycin plus cefazolin or clindamycin or 
      piperacillin/tazobactam for fracture prophylaxis. The primary outcome was the 
      rate of composite AEs, which included nephrotoxicity, surgical site infection 
      (SSI), and hospital re-admission with surgical intervention. Secondary outcomes 
      included the rate of SSI within 30 and 60 days after injury. Data were analyzed 
      using the Student t-, Mann-Whitney U, and Fisher exact tests. Results: 
      Eighty-five patients were included. There were 29 events in the tobramycin group 
      compared with three in the piperacillin/tazobactam group. At 30 days, SSI had 
      occurred in 17 patients (27.5%) in the tobramycin group and 1 patient (4.3%) in 
      the piperacillin/tazobactam group (p = 0.033). At 60 days, SSI had occurred in 
      three additional patients in the tobramycin group (p = 0.009). Conclusion: There 
      was no difference in the composite AEs in the piperacillin/tazobactam compared 
      with the tobramycin group. However, SSI within 30 and 60 days was significantly 
      more common with tobramycin.
FAU - Shawar, Suhair K
AU  - Shawar SK
AD  - Department of Pharmacy, The Ohio State University Wexner Medical Center, 
      Columbus, Ohio.
FAU - Ly, Thuan V
AU  - Ly TV
AD  - Department of Orthopaedics, The Ohio State University Wexner Medical Center, 
      Columbus, Ohio.
FAU - Li, Junan
AU  - Li J
AD  - The Ohio State University College of Pharmacy, Columbus, Ohio.
FAU - Shirk, Mary Beth
AU  - Shirk MB
AD  - Department of Pharmacy, The Ohio State University Wexner Medical Center, 
      Columbus, Ohio.
AD  - The Ohio State University College of Pharmacy, Columbus, Ohio.
FAU - Reichert, Erin M
AU  - Reichert EM
AD  - Department of Pharmacy, The Ohio State University Wexner Medical Center, 
      Columbus, Ohio.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20190805
PL  - United States
TA  - Surg Infect (Larchmt)
JT  - Surgical infections
JID - 9815642
RN  - 0 (Anti-Bacterial Agents)
RN  - 157044-21-8 (Piperacillin, Tazobactam Drug Combination)
RN  - VZ8RRZ51VK (Tobramycin)
SB  - IM
MH  - Adult
MH  - Anti-Bacterial Agents/administration & dosage/adverse effects/*therapeutic use
MH  - Antibiotic Prophylaxis/adverse effects/*methods
MH  - Female
MH  - Fractures, Open/complications/microbiology/*surgery
MH  - Humans
MH  - Male
MH  - Piperacillin, Tazobactam Drug Combination/administration & dosage/adverse 
      effects/*therapeutic use
MH  - Retrospective Studies
MH  - Surgical Wound Infection/prevention & control
MH  - Tobramycin/adverse effects/*therapeutic use
MH  - Wound Infection/etiology/microbiology/*prevention & control
OTO - NOTNLM
OT  - nephrotoxicity
OT  - surgical site infection
OT  - trauma
OT  - type III open fracture
EDAT- 2019/08/06 06:00
MHDA- 2020/11/21 06:00
CRDT- 2019/08/06 06:00
PHST- 2019/08/06 06:00 [pubmed]
PHST- 2020/11/21 06:00 [medline]
PHST- 2019/08/06 06:00 [entrez]
AID - 10.1089/sur.2019.064 [doi]
PST - ppublish
SO  - Surg Infect (Larchmt). 2020 Feb;21(1):23-28. doi: 10.1089/sur.2019.064. Epub 2019 
      Aug 5.