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 .
Risk of infection after open fracture of the arm or leg.
Two hundred forty consecutive patients admitted for operative treatment of an open fracture of the arm or leg were followed up prospect ively for the development of fracture infection . The independent risk of fracture infection was increased in patients with grade IIIB or IIIC fractures , internal or external fixation , lower-leg fracture , any blood transfusion , or injuries result ing from motorcycle accidents or motor vehicle-pedestrian accidents . By stepwise multivariate logistic regression , the most significant risk factors were the grade of the fracture , internal or external fixation , and fractures of the lower leg . These risk factors all represent local wound characteristics , and we conclude that the most important actions by the surgeon to prevent infection involve local wound care . There was no relation between the timing of antibiotic administration or duration of antibiotic therapy and infection risk
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 .