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 .
Comparison of Antibiotic Beads and Intravenous Antibiotics in Open Fractures
This study compared the efficacy of antibiotic impregnated beads with conventional intravenous antibiotics in the treatment of open fractures . A r and omized prospect i ve study was design ed and conducted during a 29-month period . Sixty-seven patients with 75 open fractures were treated similarly , with the exception of the method of antibiotic administration , and were followed up for at least 1 year after injury . Infection occurred in two of 24 ( 8.3 % ) fractures treated with antibiotic beads alone and in two of 38 ( 5.3 % ) fractures treated with conventional intravenous antibiotics . In an unanticipated nonr and omized third cohort group , patients received antibiotic beads and intravenous antibiotics administered for nonorthopaedic reasons or limb threatening injury , or both . Two of 13 ( 15.4 % ) fractures in this high risk group became infected . Infection ultimately resolved in all fractures treated with antibiotic beads alone or antibiotic beads in conjunction with conventional intravenous antibiotics . This study was unable to achieve statistical significance ; however , the data suggest antibiotic beads may be useful in preventing infection in open fractures . Thus , a larger multicenter r and omized prospect i ve study of isolated open fractures , eliminating other variables , is justified
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 .