TY - JOUR
T1 - Duration of Perioperative Antibiotic Prophylaxis in Open Fractures
T2 - A Systematic Review and Critical Appraisal
AU - Vanvelk, Niels
AU - Chen, Baixing
AU - Van Lieshout, Esther M.M.
AU - Zalavras, Charalampos
AU - Moriarty, T. Fintan
AU - Obremskey, William T.
AU - Verhofstad, Michael H.J.
AU - Metsemakers, Willem Jan
N1 - Publisher Copyright: © 2022 by the authors. Licensee MDPI, Basel, Switzerland.
PY - 2022/2/23
Y1 - 2022/2/23
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=85125440224&partnerID=8YFLogxK
U2 - 10.3390/antibiotics11030293
DO - 10.3390/antibiotics11030293
M3 - Review article
C2 - 35326757
AN - SCOPUS:85125440224
SN - 2079-6382
VL - 11
JO - Antibiotics
JF - Antibiotics
IS - 3
M1 - 293
ER -
