Abstract | BACKGROUND:
Antibiotic prophylaxis has been established policy for major surgical operations for many years. In fracture fixation, the effectiveness, and the duration of administration, have been a matter of debate. OBJECTIVES: To assess the effects of the prophylactic administration of antibiotics in patients undergoing surgical management of hip or other long bone fractures. SEARCH STRATEGY: We searched MEDLINE, EMBASE, Current Contents, Dissertation Abstracts, and Index to UK Theses, and bibliographies of identified articles. Trials were also obtained from the Cochrane Musculoskeletal Injuries Group trials register. Date of the most recent search: end of 1997. SELECTION CRITERIA: PARTICIPANTS: INTERVENTIONS: OUTCOME MEASURES: DATA COLLECTION AND ANALYSIS: Both reviewers independently selected trials for inclusion, and assessed methodological quality and extracted data. Where possible, data were pooled and Peto odds ratios and absolute risk reductions, each with 95% confidence intervals, calculated. MAIN RESULTS: Twenty one randomised trials of only poor or moderate quality were included. The comparisons tested fell within six comparison groups, principally multiple dose or a single dose of antibiotic versus a placebo or no treatment. Antibiotic prophylaxis reduces wound, urinary and respiratory tract infections in patients undergoing surgery for closed fracture fixation. Economic modelling has indicated that this is a cost-effective intervention. There are limited data for the incidence of adverse effects, but as expected they appear to be more common in those receiving antibiotics. REVIEWER'S CONCLUSIONS:
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Authors | W J Gillespie, G Walenkamp |
Journal | The Cochrane database of systematic reviews
(Cochrane Database Syst Rev)
Issue 2
Pg. CD000244
( 2000)
ISSN: 1469-493X [Electronic] England |
PMID | 10796333
(Publication Type: Journal Article, Review, Systematic Review)
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Topics |
- Antibiotic Prophylaxis
- Arthroplasty
- Femoral Fractures
(surgery)
- Fracture Fixation, Internal
- Fractures, Closed
(surgery)
- Hip Fractures
(surgery)
- Humans
- Orthopedic Procedures
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