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 .
Antibiotic prophylaxis in open and closed fractures: a controlled clinical trial.
The value of prophylactic antibiotics in fracture surgery was studied in a series of 90 patients with open fractures of various bones and 180 patients with closed malleolar fractures treated by open surgery .  Dicloxacillin and benzyl penicillin were compared to saline ( placebo ) . The soft tissue lesions of the open fractures were divided into Grade I wounds and Grade II & III wounds . Of the patients with Grade I wounds , 17 received dicloxacillin , 21 benzyl penicillin and 17 saline . No major infections occurred . Twelve patients with Grade II & III wounds were treated with dicloxacillin , 10 with benzyl penicillin and 13 with saline . In the saline group , 2 patients developed a deep infection .  Fifty-eight patients with closed malleolar fractures received dicloxacillin , 59 benzyl penicillin and 63 saline . Two infections developed in the placebo group . A statistically significant difference was found between the number of infections in the antibiotic groups and the number in the placebo group . Superficial thromboplebitis following the antibiotic infusion occurred in 16 per cent of the dicloxacillin treated patients and in 1 per cent of those treated with benzyl penicillin or placebo
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 .