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

摘要: Background Surgical site infection and other hospital-acquired infections cause significant morbidity after internal fixation of fractures. The administration antibiotics may reduce the frequency infections. Objectives To determine whether prophylactic in people undergoing surgical management hip or closed long bone fractures reduces incidence infections. Search methods We searched Cochrane Bone, Joint Muscle Trauma Group Specialised Register (December 2009), Central Controlled Trials (The Library 2009, Issue 4), MEDLINE (1950 to November EMBASE (1988 December electronic databases including WHO International Clinical Registry Platform conferences proceedings reference lists articles. Selection criteria Randomised quasi-randomised controlled trials comparing any regimen systemic antibiotic prophylaxis administered at time surgery, compared with no prophylaxis, placebo, a different duration, fracture surgery for prosthetic replacement, fixation. All needed report infection. Data collection analysis Two authors independently screened papers inclusion, assessed risk bias extracted data. Pooled data are presented graphically. Main results Data from 8447 participants 23 studies were included analyses. In fixation, single dose significantly reduced deep (risk ratio 0.40, 95% CI 0.24 0.67), superficial infections, urinary respiratory tract infections. Multiple had an effect similar size on 0.35, 0.19 0.62), but effects not confirmed. Although many as reported was unclear, sensitivity analysis showed that removal meta-analyses high did alter conclusions. Economic modelling using one large trial indicated ceftriaxone is cost-effective intervention. Data adverse very limited, expected they appeared be more common those receiving antibiotics, placebo prophylaxis. Authors' conclusions Antibiotic should offered