Multidisciplinary standardized protocol decreases time to antibiotic administration for open fractures

Area of Science:

• Trauma surgery
• Orthopedic surgery
• Infectious disease prevention

Background:

• Open fractures are prone to wound complications like infections.
• Early prophylactic antibiotics are crucial for reducing infection rates.
• Optimizing antibiotic timing is a modifiable factor in open fracture management.

Purpose of the Study:

• To evaluate the impact of a standardized open fracture protocol on the timing of antibiotic administration.
• To assess the proportion of patients receiving antibiotics within one hour of arrival.
• To identify factors influencing antibiotic administration delays.

Main Methods:

• Retrospective comparative study at a Level 1 Trauma Center.
• Involved adult patients with open long-bone fractures.
• Compared antibiotic administration times pre- and post-protocol implementation.

Main Results:

• Median time to antibiotic administration decreased from 69 to 39 minutes post-protocol (p < 0.001).
• The percentage of patients receiving antibiotics within one hour increased from 42.9% to 79.0% (p < 0.001).
• Penetrating injuries experienced longer delays in antibiotic administration compared to blunt injuries.

Conclusions:

• Standardized protocols effectively reduce time to antibiotic administration for open fractures.
• Timely antibiotics are critical for preventing wound infections after open fractures.
• Penetrating injuries require careful initial evaluation to avoid delays in antibiotic treatment.