What is the most optimal prophylaxtic antibiotic coverage and treatment duration for open fractures of long bones?

Authors: Willem-Jan Metsemakers, Charalampos Zalavras

RECOMMENDATION: The use of prophylactic antibiotics for open fractures of long bones has a protective effect against early infection. Antibiotics should be administered as soon as possible after the injury. The antibiotic of choice should target gram-positive organisms. Additional coverage for gram-negative organisms should be considered for patients with high-energy open fractures. Antibiotics should not be continued for more than 72 hours after wound closure.

LEVEL OF EVIDENCE: • Efficacy of prophylactic antibiotics – Strong • Timing of prophylactic antibiotics – Moderate • Choice of antibiotics – Limited • Treatment duration – Moderate

DELEGATE VOTE: Agree: 100%, Disagree: 0%, Abstain: 0% (Unanimous, Strongest Consensus)