Monotherapy Antibiotic Prophylaxis of Lower Extremity Long Bone Type III Open Fractures.
Thomas W RobinsonCorinne E GautreauxYann-Leei L LeeMaryann MbakaChristopher M KinnardAndrew C BrightAshley Y WilliamsNathan M PoliteThomas J CapassoJon D SimmonsCharles C ButtsPublished in: The American surgeon (2024)
Gustilo type III open fractures involve extensive soft tissue damage and wound contamination that pose significant infection risks. The historical standard for antibiotic prophylaxis has been cefazolin and gentamicin. We conducted a retrospective cohort study of lower extremity type III open fractures treated with ceftriaxone alone for prophylaxis. Eighty-six patients were identified. Nearly all (98%) were managed with appropriate antibiotics, but only 55 (64%) received prophylaxis within 1 hour. Overall, there were 12 infections. This infection rate was not statistically different than the reported literature (14% vs 19%, P = .20). The infection rate between those who received antibiotics within 1 hour was not statistically different from those who got it beyond 1 hour (15% vs 13%, P = .98). In conclusion, the use of ceftriaxone as monotherapy for antibiotic prophylaxis in lower extremity type III open fractures is not statistically different than the use of historic prophylactic regimens.
Keyphrases
- type iii
- minimally invasive
- blood pressure
- soft tissue
- end stage renal disease
- newly diagnosed
- systematic review
- chronic kidney disease
- risk assessment
- ejection fraction
- open label
- oxidative stress
- human health
- combination therapy
- randomized controlled trial
- clinical trial
- bone mineral density
- patient reported outcomes
- health risk
- patient reported
- double blind