A Simple Initiative to Decrease Time to Antibiotic Prophylaxis for Open Fractures Is Durable After 2 Years

Area of Science:

• Trauma Surgery
• Infectious Disease Prevention
• Emergency Medicine

Background:

• Open fractures require timely antibiotic prophylaxis to prevent infection.
• A simple initiative was implemented to decrease antibiotic administration time.
• The study assessed the long-term adherence to this protocol.

Purpose of the Study:

• To evaluate the durability of a simple antibiotic prophylaxis initiative.
• To determine if adherence to antibiotic administration protocols for open fractures decreases over time.
• To assess the impact on infection rates.

Main Methods:

• Retrospective cohort study of adult open fracture patients.
• Three groups: preimplementation, immediate postimplementation, and 2-year retention.
• Primary outcome: time to antibiotic administration; secondary: % within 60 min, infection rates.

Main Results:

• Time to antibiotics decreased from 123.1 to 35.7 minutes, remaining durable at 50.0 minutes.
• % receiving antibiotics within 60 min increased from 46% to 82% and stayed at 80%.
• Higher Gustilo-Anderson type, lower extremity injury, and male sex were associated with timely antibiotics.

Conclusions:

• A simple educational initiative for antibiotic prophylaxis in open fractures demonstrated durable results.
• The protocol significantly reduced time to antibiotic administration for open fractures.
• Sustained adherence to antibiotic prophylaxis protocols is achievable.