Antibiotic prophylaxis for surgery for proximal femoral and other closed long bone fractures

Infection of bone and soft tissues can result after bone fractures. Fractures which penetrate the skin are called 'open' or 'compound'. If the skin remains intact despite the fracture, it is called 'simple' or 'closed'. If a closed fracture is treated by a surgical operation, bacteria can contaminate the wound, and cause surgical site infection. This, and other hospital-acquired infections, can be life threatening in people following surgery for thigh and other closed long bone fractures. Antibiotics have been given routinely since the 1970s in an effort to reduce infections from bacteria such as staphylococcus. This review included 23 trials, involving a total of 8447 participants. The review found that antibiotics are effective in reducing the incidence of infection, both at the surgical-wound site and in the chest and urinary tract. The effect of a single dose of antibiotic is similar to that from multiple doses if the antibiotic chosen is active through the period from the beginning of surgery until the wound is sealed. There were too few data available to confirm the expected tendency for increased adverse drug-related events such as gut problems and skin reactions.