Assessment of Prophylactic Antibiotic Coverage in Culture-positive Traumatic Open Fractures

Area of Science:

• Orthopedic Surgery
• Infectious Disease
• Pharmacology

Background:

• Guidelines for prophylactic antimicrobial treatment of open fractures vary.
• Assessing the effectiveness of institutional antibiotic protocols is crucial.

Purpose of the Study:

• To evaluate the coverage of an institutional prophylactic antibiotic protocol against pathogens in open fractures.
• To compare outcomes between patients with and without adequate antibiotic coverage.

Main Methods:

• Retrospective cohort study of adult trauma patients with open fractures and positive cultures.
• Analysis of 75 patients, comparing those covered by prophylactic antibiotics versus those not covered.

Main Results:

• 53% of included patients received prophylactic antibiotics.
• Multidrug-resistant pathogens were common in both groups (58% covered vs. 74% not covered).
• Patients not covered by initial antibiotics had a significantly shorter median time to positive culture (30.2 days vs. 102.1 days).

Conclusions:

• The institutional prophylactic antibiotic protocol demonstrated partial effectiveness in covering open fracture pathogens.
• Further optimization of antibiotic strategies is warranted to improve patient outcomes and reduce infection risks.