Perioperative antibiotic prophylaxis in long bone open fractures: the need for randomized controlled trials

Declercq, Peter; Zalavras, Charalampos G.; Mertens, Beatrijs; Linden, Lorenz Van der; Nijs, Stefaan; Spriet, Isabel; Metsemakers, Willem‐Jan

doi:10.1007/s00402-021-03796-1

Cited by 2 publications

(4 citation statements)

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“…AMR is a major issue in clinical practice today and considered one of the important global health challenges of the twenty-first century [12]. Therefore, physicians are becoming aware of the importance of limiting antibiotic use [9,12]. Improving and following PAP guidelines will be a priority in the future to limit the increasing prevalence of multidrug-resistant pathogens [39].…”

Section: Future Directionsmentioning

confidence: 99%

“…Many of these current strategies, such as the type of soft tissue coverage, timing of surgery, and application of local antibiotics, are however still under debate [8,9].…”

Section: Introductionmentioning

confidence: 99%

“…Recent international surveys among orthopaedic trauma surgeons indeed concluded that the majority of surgeons continue PAP longer than recommended [1,11], which leads to an important antibiotic overuse [12]. Although PAP overuse may be attributed to the fact that open fractures are often complex injuries with a high FRI risk, it seems that the primary reason for divergent treatments is the lack of well-conducted studies establishing the optimal PAP duration [9].…”

Section: Introductionmentioning

confidence: 99%

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Duration of Perioperative Antibiotic Prophylaxis in Open Fractures: A Systematic Review and Critical Appraisal

et al. 2022

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Fracture-related infection (FRI) remains a serious complication in open fracture care. Adequate surgical treatment and perioperative antibiotic prophylaxis (PAP) are key factors influencing the outcome. However, data concerning the optimal duration of PAP is scarce. The aim of this systematic review was to provide an overview of current evidence on the association between PAP duration and FRI in open fractures. A comprehensive search on 13 January 2022, in Embase, Medline, Cochrane, Web of Science and Google Scholar revealed six articles. Most studies compared either 1 day versus 5 days of PAP or included a cut-off at 72 h. Although prolonged PAP was not beneficial in the majority of patients, the variety of antibiotic regimens, short follow-up periods and unclear description of outcome parameters were important limitations that were encountered in most studies. This systematic review demonstrates a lack of well-constructed studies investigating the effect of PAP duration on FRI. Based on the available studies, prolonged PAP does not appear to be beneficial in the prevention of FRI in open fractures. However, these results should be interpreted with caution since all included studies had limitations. Future randomized trials are necessary to answer this research question definitively.

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Section: Future Directionsmentioning

confidence: 99%

“…Many of these current strategies, such as the type of soft tissue coverage, timing of surgery, and application of local antibiotics, are however still under debate [8,9].…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Duration of Perioperative Antibiotic Prophylaxis in Open Fractures: A Systematic Review and Critical Appraisal

et al. 2022

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“…Recent international surveys among maxillofacial trauma surgeons indeed concluded that most surgeons continue antibiotic prophylaxis longer than proposed, which leads to an important overuse of antibiotics [16,17]. Similar issues are currently encountered in infection prevention protocols for long-bone fractures [18,19].…”

Section: Introductionmentioning

confidence: 97%

Systemic Antibiotic Prophylaxis in Maxillofacial Trauma: A Scoping Review and Critical Appraisal

et al. 2022

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Infection after maxillofacial trauma remains an important complication, with a significant socio-economic impact. While consensus exists that systemic antibiotic prophylaxis reduces the risk of infection in the management of maxillofacial fractures, the type, and duration remain controversial. Therefore, the purpose of this scoping review was to provide an overview of the current evidence that supports the use of prophylactic antibiotics in the treatment of maxillofacial fractures. A comprehensive literature search on 1 January 2022, in PubMed, Web of Science, Embase, and Cochrane, revealed 16 articles. Most studies focused on the duration of systemic antibiotic prophylaxis and compared a one-day to a five-day regimen. Included studies showed considerable variability in design and research aims, which rendered them difficult to compare. Furthermore, a variety of antibiotic regimens were used, and most studies had a short follow-up period and unclear outcome parameters. This scoping review demonstrates the lack of well-constructed studies investigating the type and duration of systemic antibiotic prophylaxis in the treatment of maxillofacial trauma. Based on the included articles, prolonging antibiotic prophylaxis over 24 h for surgically treated fractures does not appear to be beneficial. Furthermore, there is no evidence for its use in conservatively treated fractures. These results should be interpreted with caution since all included studies had limitations.

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Perioperative antibiotic prophylaxis in long bone open fractures: the need for randomized controlled trials

Cited by 2 publications

References 10 publications

Duration of Perioperative Antibiotic Prophylaxis in Open Fractures: A Systematic Review and Critical Appraisal

Duration of Perioperative Antibiotic Prophylaxis in Open Fractures: A Systematic Review and Critical Appraisal

Systemic Antibiotic Prophylaxis in Maxillofacial Trauma: A Scoping Review and Critical Appraisal

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