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 .
Clindamycin versus cloxacillin in the treatment of 240 open fractures. A randomized prospective study.
BACKGROUND AND AIMS Systemic administration of antibiotics is recommended and has proved to lower infection rates in open fractures . However , no antibiotic has proved to be superior to any other . MATERIAL AND METHODS In a prospect i ve study 227 patients with 240 open fractures were r and omized to receive either clindamycin or cloxacillin for infection prevention . RESULTS The overall infection rate was 15 % . Infection occurred in 9.3 % of the clindamycin treated and in 20 % of the cloxacillin treated fractures ( p < 0.05 ) . In the Gustillo Type I and II open fractures all the pathogens causing infection were gram-positive , while in the Type III open fractures 21 pathogens ( 57 % ) were gram-positive and 16 ( 43 % ) gram-negative . In the clindamycin treated fractures the infection rates in Type I and II open fractures were 3.3 and 1.8 % , respectively , while in the cloxacillin group they were 20 and 3.8 % , respectively . Both clindamycin and cloxacillin showed low effectiveness in the treatment of Type III open fractures , the highest infection rates being 75 and 67 % , respectively ( Type III B ) . CONCLUSIONS Clindamycin provides good antimicrobic coverage against the most common pathogens causing Type I and II open fracture infections . In the treatment of Type III open fractures additional administration of an antibiotic with good gram-negative coverage is recommended
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 .