Results of r and omized controlled trials performed to date provide evidence that antibiotic prophylaxis reduces subsequent infection and that courses as short as one day are as effective as courses of three to five days , although the evidence warrants only low to moderate confidence .
BACKGROUND The purpose of the present study was to perform a systematic review and meta- analysis of the use of alternative antibiotic regimens-including ( A ) antibiotic prophylaxis versus no prophylaxis , ( B ) longer versus shorter duration of antibiotic prophylaxis , and ( C ) alternative drugs-for  patients with open fracture of the extremities .
Severe Open Tibial Fractures: A Study Protocol
A prospect i ve r and omized study of severe open tibial fractures ( Type II and III ) was performed . Individual fractures were r and omized to treatment groups according to initial antibiotic therapy : One consisted of a first-generation cephalosporin , and the other consisted of a third-generation cephalosporin . Initial antibiotic therapy was given in all patients for 48 h and then specific antibiotic treatment was used as indicated by culture . The purpose of this study was to determine whether or not additional gram-negative coverage had an effect on the overall infection rate or the type of infection in severe open tibial fractures . Additional factors , such as the timing of bone grafts and soft tissue coverage , were evaluated in this study as well . Although there was no statistical difference in the rate of infection with the use of a first-versus a third-generation cephalosporin , there was a trend toward a decreased infection rate as well as toward less morbid infections with the use of a third-generation cephalosporin . The study also confirms that early bone graft should not be performed prior to 6 weeks post injury or after successful soft tissue coverage has been achieved . On the other h and , soft tissue coverage procedures should be performed at the earliest possible date to decrease the overall infection rate
Results of r and omized controlled trials performed to date provide evidence that antibiotic prophylaxis reduces subsequent infection and that courses as short as one day are as effective as courses of three to five days , although the evidence warrants only low to moderate confidence .
BACKGROUND The purpose of the present study was to perform a systematic review and meta- analysis of the use of alternative antibiotic regimens-including ( A ) antibiotic prophylaxis versus no prophylaxis , ( B ) longer versus shorter duration of antibiotic prophylaxis , and ( C ) alternative drugs-for  patients with open fracture of the extremities .