title: The use of prophylactic antibiotics in treatment of fingertip amputation: a randomized prospective trial.
abstract: OBJECTIVE
  Fingertip amputation is a common injury. Considerable controversy exists as to whether prophylactic antibiotics are necessary for this injury. Our goal was to compare the rate of infections among subgroups with and without prophylactic antibiotic treatment. The study hypothesis was that infection rates were similar in the 2 groups.
  
  
  METHODS
  This was a prospective randomized control trial of adult patients presenting with fingertip amputation with bone exposed, requiring surgical treatment. Patients were randomized to 2 groups: group 1 received no antibiotics, and group 2 received 1 g intravenous antibiotics (cefazolin) for 3 days. The 2 groups were matched for age, time to surgery, injury mechanism, and type of surgery. All surgical treatments were performed in the operating room, and all patients were reevaluated in our outpatient clinic after 10 days and again after a month. The primary outcome measure was the rate of infection.
  
  
  RESULTS
  Fifty-eight patients were initially enrolled in the study; 2 patients withdrew before study completion, 29 subjects were randomized to the no-antibiotic group, and 27 subjects were randomized to the antibiotic group. No statistically significant differences on any baseline values were found between the 2 treatment groups. There was no infection in either group at the end of follow-up.
  
  
  CONCLUSIONS
  This study suggests that routine prophylactic antibiotics do not reduce the rate of infection after fingertip amputations with bone exposed treated surgically in the operating room.
authors: Orthopedic Department, Ha'Emek Medical Center, Afula, Israel; Hand Surgery Unit, Orthopedic Department, Ha'Emek Medical Center, Afula, Israel; Faculty of Medicine, Technion, Haifa, Israel. Electronic address: guytalr@bezeqint.net.
authors: Guy
authors: G
authors: Rubin
authors: Orthopedic Department, Ha'Emek Medical Center, Afula, Israel.
authors: Hagay
authors: H
authors: Orbach
authors: Orthopedic Department, Ha'Emek Medical Center, Afula, Israel; Hand Surgery Unit, Orthopedic Department, Ha'Emek Medical Center, Afula, Israel.
authors: Micha
authors: M
authors: Rinott
authors: Orthopedic Department, Ha'Emek Medical Center, Afula, Israel; Hand Surgery Unit, Orthopedic Department, Ha'Emek Medical Center, Afula, Israel.
authors: Alejandro
authors: A
authors: Wolovelsky
authors: Orthopedic Department, Ha'Emek Medical Center, Afula, Israel; Faculty of Medicine, Technion, Haifa, Israel.
authors: Nimrod
authors: N
authors: Rozen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000671:Amputation, Surgical; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis; D002437:Cefazolin / Q000627:therapeutic use*; D005260:Female; D005383:Finger Injuries / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013530:Surgical Wound Infection / Q000517:prevention & control*; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D002437:Cefazolin