Longer antibiotic course may not improve infection outcomes after fracture fixation
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Key takeaways:
- Results showed a longer course of antibiotics may not improve surgery-free survival in patients with infection after fracture fixation.
- Identification of the best antimicrobial management is needed.
A longer course of antibiotics may not be associated with improved rates of surgery-free survival in patients with infection after fracture fixation, according to recently presented data.
“In conclusion, longer courses of antibiotics were not significantly associated with surgery-free survival among patients with [infection after fracture fixation] IAFF,” Jessica L. Seidelman, MD, MHP, said in a presentation at the Musculoskeletal Infection Society Annual Meeting. “But future studies are desperately needed.”
Seidelman and colleagues evaluated surgery-free survival after completion of antibiotics among 117 patients who underwent open reduction and internal fixation for long-bone trauma, had subsequent debridement surgery and completed at least a 2-week antibiotic course. Researchers categorized patients into groups based on whether they received either no more than 6 weeks of antibiotics or more than 6 weeks of antibiotics.
“We also wanted to see if there was greater surgery-free survival associated with non-Staphylococcal IAFFs compared to Staphylococcal IAFFs,” Seidelman said.
Researchers found no statistically significant differences between long- and short-term antibiotic groups or between Staphylococcal and non-Staphylococcal groups.
“One of the biggest takeaways from this study is that studies surrounding antibiotic treatment for IAFF ... are challenging,” Seidelman said. “We screened over 1,000 patients from four academic institutions, and we only came out with a little over 100 patients, which still left us without adequate power to fully answer the question that we wanted to.”
“Randomized studies are needed to identify the best antimicrobial management,” she concluded.
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Seidelman JL, et al. Paper 1088. Presented at: Musculoskeletal Infection Society Annual Meeting; Aug. 4-5, 2023; Salt Lake City (hybrid meeting).
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