Antibiotics for Preventing Infection in Open Limb Fractures

This week, as part of the Child Health Emergency Medicine Social Media Campaign, we are highlighting a Cochrane summary on antibiotics for preventing infection in open limb fractures. This review was selected for the TREKK Evidence Repository on fractures.

Key Messages:


Related TREKK Resources:

Cochrane Summary:

Antibiotics for preventing infection in open limb fractures

Wound and bone infections are common complications following open fractures of the limbs. For more than 20 years in developed countries, the use of antibiotics has been a part of a standard management protocol that also includes washing the wound (irrigation), cleaning up the wound and fracture (surgical debridement), and stabilisation of the fracture, as required. This review, which included data from 1106 participants in eight trials, found that antibiotics are effective in decreasing the incidence of wound infections, as compared with no antibiotics or placebo. No studies reporting bone infection or long-term ill health (morbidity) were identified.

Authors’ Conclusions:

Antibiotics reduce the incidence of early infections in open fractures of the limbs. Further placebo controlled randomised trials are unlikely to be justified in middle and high income countries, except for open fractures of the fingers. Further research is necessary to the determine the avoidable burden of morbidity in countries where antibiotics are not used routinely in the management of open fractures.

Check Out the Full Cochrane Systematic Review Below:

Gosselin, R.A., Roberts, I., Gillespie, W.J. (2004). Antibiotics for preventing infection in open limb fractures. Cochrane Database Syst Rev, 1, CD003764. doi: 10.1002/14651858.CD003764.pub2

The Cochrane Bone, Joint and Muscle Trauma Group also recommends the following systematic reviews related to fractures in children:

Black, K.J., Bevan, C.A., Murphy, N.G., Howard, J.J. (2013). Nerve blocks for initial pain management of femoral fractures in children. Cochrane Database Syst Rev, 12, CD009587. doi: 10.1002/14651858.CD009587.pub2

Yeung, D.E., Jia, X., Miller, C.A., Barker, S.L. (2016). Interventions for treating ankle fractures in children. Cochrane Database Syst Rev, 4, CD010836. doi: 10.1002/14651858.CD010836.pub2


This post is part of a weekly blog series highlighting pediatric emergency medicine (PEM) focused Cochrane summaries and other key resources selected by TREKK.

Published by arrangement with John Wiley & Sons.