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 .
Treatment of open fractures: a prospective study.
A double-blind prospect i ve study was done to assess the benefit of delaying closure of the wounds associated with open fractures . An additional double-blind study compared the effectiveness of clindamycin versus cefazolin for prophylactic antibiotic coverage . Quantitative cultures of the wounds were accomplished at the time of debridement and again at the time of closure if the wound was not closed initially . Almost half of the wounds were contaminated ( 46 % ) at the time of debridement , although the incidence of wound infection was low ( 6.5 % ) . Gram-negative organisms resistant to the prophylactic antibiotic were recovered initially only eight times , but four of these ( 50 % ) became infected . The contaminating organisms in each case were present in high concentration ( greater than 10(5 ) CFU/gm of tissue ) at initial culture . The time of wound closure , cefazolin versus clindamycin , and internal fixation of the fracture were not followed by significant differences in the development of clinical infection in this series
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 .