Open limb fractures: How well do antibiotics protect against wound infection?
Antibiotics improve healing and prevent infections after open limb fractures, and they are a key element of treatment.
An open limb fracture is when a broken bone comes through the skin. When this happens it is almost impossible to stop germs from getting into the wound.
Often this has no consequences. However, if the wound becomes infected or even starts to fester, it can badly interfere with the healing of the wound and the bone. In extreme cases this can even lead to the need for amputation.
To prevent these kinds of complications, the wound is usually cleaned and damaged tissue is removed when necessary. It is routine in Germany for patients to be given several days of antibiotic treatment.
To find out how necessary this is, researchers from the Cochrane Collaboration gathered and analyzed trials testing this treatment. They found 8 trials, in which more than 1,100 patients with open fractures of the finger, hand, arm or leg tested antibiotic treatment.
The results clearly supported routine antibiotics. Out of 100 patients who had no antibiotics, 13 developed a wound infection in the days after the fracture (13%). But out of 100 patients who got antibiotics, there were only 6 infections (6%). A further finding was that antibiotics give the most protection when they are started early, preferably in the first 6 to 8 hours after the break. The trials could not show, however, whether any particular antibiotic is better than any other.
The benefit was so clear that the researchers concluded that antibiotic treatment after an open limb fracture is a basic element of care, and should not just be seen as a precaution. This assumes, of course, that patients follow through and take the medication as prescribed.
Researchers from the Cochrane Collaboration are currently analyzing further trials on the use of antibiotics in open limb fractures. It is already clear that the latest research confirms the previous results: treatment with antibiotics can continue to be considered a basic element of care.
Author: German Institute for Quality and Efficiency in Health Care (IQWiG)
- Created (German version): February 14th 2006 10:00
- Published: January 18th 2011 15:56
Reference: IQWiG health information is based on research in the international literature. We identify the most scientifically reliable knowledge currently available, particularly so-called “systematic reviews”. These summarize and analyze the results of scientific research on the benefits and harms of treatments and other health care interventions. You can read more about systematic reviews and why these can provide the most trustworthy evidence about the state of knowledge here (URL: http://www.informedhealthonline.org/index.61.en.html) . The authors of the major systematic reviews on which our information is based are always approached to help us ensure the medical and scientific accuracy of our products.
Gosselin RA, Roberts I, Gillespie WJ. Antibiotics for preventing infection in open limb fractures. Cochrane Database of Systematic Reviews: Version 2009, Issue 4. CD003764 [Cochrane summary]