title: A retrospective study of antibiotic prophylaxis value in surgical treatment of lower limb fracture.
abstract: BACKGROUND
  Surgical site infections (SSI) are nosocomial infections that cause considerable problems in orthopaedic surgery. Antibiotic prophylaxis can be used to reduce the risk for SSI. There is no universal antibiotic that can be recommended for prophylaxis in terms of coverage of all possible pathogens because of antibiotic resistance, and there are no universal recommendations for different types of patients in terms of injury type, selected operation and risk factors for development of SSI. The aim of this study was to analyse the effectiveness of antibiotic prophylaxis in surgical treatment (ORIF) of closed lower limb fractures in young, healthy patients.
  
  
  METHODS
  Patient details were collected from the patient histories. Inclusion criteria for participants were age 20-30 years, not suffering from any type of chronic disease or state that may affect postoperative infection and ISS≤9. Antibiotic prophylaxis use and outcome (SSI) were compared between two groups of patients. Data were analysed using descriptive statistics, Fisher's exact test and t-test for proportions.
  
  
  RESULTS
  A total of 347 patients with closed lower limb fractures treated with ORIF met the inclusion criteria. There were 290 male and 57 female patients, with an average age of 24.47 years. Prophylactic antibiotics were given to 242 patients (69.74%); 2g ceftriaxone was administered to 88.02% of the patients who received antibiotic prophylaxis. Ten patients developed postoperative infection (eight out of 242 with antibiotic prophylaxis and two out of 105 without antibiotic prophylaxis). The difference between the two groups was not statistically significant (Fisher's exact test, P=0.749).
  
  
  CONCLUSIONS
  Antibiotic prophylaxis was ineffective in preventing SSI in patients with no risk factors for SSI who were undergoing ORIF for closed lower limb fractures.
authors.affiliation: Clinical Department of Traumatology, University Hospital Split, Split, Croatia. Electronic address: antebandalovic@gmail.com.
authors.forename: Ante
authors.initials: A
authors.lastname: Bandalović
authors.affiliation: Department of Surgery, General Hospital Šibenik, Šibenik, Croatia.
authors.forename: Antonija
authors.initials: A
authors.lastname: Zindović
authors.affiliation: Clinical Department of Traumatology, University Hospital Split, Split, Croatia.
authors.forename: Vladimir
authors.initials: V
authors.lastname: Boschi
authors.affiliation: Department of Surgery, General Hospital Karlovac, Karlovac, Croatia.
authors.forename: Bore
authors.initials: B
authors.lastname: Bakota
authors.affiliation: Department of Surgery, University Hospital Rijeka, Rijeka, Croatia.
authors.forename: Marin
authors.initials: M
authors.lastname: Marinović
authors.affiliation: Institute for Anthropological Research, Zagreb, Croatia.
authors.forename: Miran
authors.initials: M
authors.lastname: Čoklo
authors.affiliation: Clinical Department of Traumatology, University Hospital Split, Split, Croatia.
authors.forename: Matko
authors.initials: M
authors.lastname: Rošin
authors.affiliation: Clinical Department of Traumatology, University Hospital Split, Split, Croatia.
authors.forename: Zlatko
authors.initials: Z
authors.lastname: Parać
authors.affiliation: Clinical Department of Traumatology, University Hospital Split, Split, Croatia.
authors.forename: Fabijan
authors.initials: F
authors.lastname: Čukelj
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D019072:Antibiotic Prophylaxis; D017523:Croatia; D005260:Female; D005360:Fibula / Q000473:pathology*; D005593:Fracture Fixation, Internal / Q000009:adverse effects / Q000379:methods*; D050723:Fractures, Bone / Q000150:complications / Q000382:microbiology / Q000601:surgery*; D006801:Humans; D008297:Male; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000382:microbiology / Q000517:prevention & control*; D013977:Tibia / Q000473:pathology*; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents
keywords: Antibiotic; Infection; MRSA; ORIF