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 .
Once daily, high dose versus divided, low dose gentamicin for open fractures.
A prospect i ve , r and omized study was performed on 75 Gustilo Grade s II and III open fractures to determine the efficacy of once daily , high dose aminoglycoside therapy , compared with more conventional dosing , in reducing the infection rate when used in conjunction with an aggressive operative treatment protocol . All patients enrolled in the study were treated with immediate irrigation , debridement , operative stabilization of the fracture , and 1 g of cefazolin every 8 hours . At the time of admission patients were r and omized to two groups . Patients in Group I received gentamicin 5 mg/kg divided into twice daily doses , and patients in Group II received gentamicin 6 mg/kg given once daily . All patients were monitored for renal toxicity and observed for radiographic and clinical signs of infection until fracture union . The results of the study revealed no statistically significant difference between once daily , high dose versus divided , low dose gentamicin in infection rates . Thus , daily dosing of gentamicin was found to be safe , effective , and cost efficient in the treatment of open fractures when combined with a cephalosporin and aggressive operative debridement and stabilization
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 .