Template:Antibiotics Open Fracture: Difference between revisions
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====Special Considerations==== | ====Special Considerations==== | ||
*Concern for [[ | *Concern for [[clostridium]] (soil contamination, farm injuries, possible bowel contamination) | ||
**Additionally add [[penicillin]]<ref>HoffWS, Bonadies JA, Cachecho R, Dorlac WC: East practice management guidelines work group: Update to practice management guidelines for prophylactic antibiotic use in open fractures. J Trauma 2011;70:751-754.</ref> | |||
**single drug regimen of [[Pipericillin/Tazobactam]] 4.5g (80mg/kg) IV TID | |||
*Fresh water wounds: [[fluoroquinolones]] OR 3rd/4th generation [[cephalosporin]] | *Fresh water wounds: [[fluoroquinolones]] OR 3rd/4th generation [[cephalosporin]] | ||
*Saltwater wounds: [[doxycycline]] + [[ceftazidime]] OR [[fluoroquinolone]] | *Saltwater wounds: [[doxycycline]] + [[ceftazidime]] OR [[fluoroquinolone]] | ||
Revision as of 09:51, 14 May 2022
Prophylactic Antibiotics for Open fractures
Initiate as soon as possible; increased infection rate when delayed[1]
Grade I & II Fractures Options
- Cefazolin (Ancef) 2 g IV (immediately and q8 hours x 3 total doses)[2]
- Allergy to above: clindamycin 900 mg IV (immediately and q8 hours x 3 total doses)[3]
Grade III Fracture Options
- Ceftriaxone 2 g IV (immediately x 1 total dose) PLUS vancomycin 1 g IV (immediately and q12 hours x 2 total doses)[4]
- Cephalosporin allergy: aztreonam 2 g IV (immediately and q8 hours x 3) PLUS [[vancomycin] 1 g IV (immediately and q12 hours x 2 total doses)[5]
Special Considerations
- Concern for clostridium (soil contamination, farm injuries, possible bowel contamination)
- Additionally add penicillin[6]
- single drug regimen of Pipericillin/Tazobactam 4.5g (80mg/kg) IV TID
- Fresh water wounds: fluoroquinolones OR 3rd/4th generation cephalosporin
- Saltwater wounds: doxycycline + ceftazidime OR fluoroquinolone
- ↑ Gosselin RA, et al. Antibiotics for preventing infection in open limb fractures. Cochrane Database Syst Rev. 2004; (1):CD003764.
- ↑ Garner MR, et al. Antibiotic Prophylaxis in Open Fractures: Evidence, Evolving Issues, and Recommendations. Journal of the American Academy of Orthopaedic Surgeons. April 15, 2020. 28(8):309-315
- ↑ Garner MR, et al. Antibiotic Prophylaxis in Open Fractures: Evidence, Evolving Issues, and Recommendations. Journal of the American Academy of Orthopaedic Surgeons. April 15, 2020. 28(8):309-315
- ↑ Garner MR, et al. Antibiotic Prophylaxis in Open Fractures: Evidence, Evolving Issues, and Recommendations. Journal of the American Academy of Orthopaedic Surgeons. April 15, 2020. 28(8):309-315
- ↑ Garner MR, et al. Antibiotic Prophylaxis in Open Fractures: Evidence, Evolving Issues, and Recommendations. Journal of the American Academy of Orthopaedic Surgeons. April 15, 2020. 28(8):309-315
- ↑ HoffWS, Bonadies JA, Cachecho R, Dorlac WC: East practice management guidelines work group: Update to practice management guidelines for prophylactic antibiotic use in open fractures. J Trauma 2011;70:751-754.