SynthesisThe Cochrane database of systematic reviews2000
Antibiotic prophylaxis for surgery for proximal femoral and other closed long bone fractures.
Synthesis in The Cochrane database of systematic reviews, 2000. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
9 citing papers in PubMed, 2 syntheses or guidelines pooled it, 83 citations in OpenAlex.
- Hip fracture.BMJ clinical evidence · 2010Pooled it
- [Management strategies in the first operative phase after long-bone injury of the lower extremity in multiple-injured patients. A systematic literature review].Der Unfallchirurg · 2005Pooled it
- Pre-operative Colonization byRevista brasileira de ortopedia · 2022Article
- Arthroscopic rotator cuff repair without antibiotic prophylaxis does not increase the infection rate.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2021Article
- Secular reduction of excess mortality in hip fracture patients >85 years.BMC geriatrics · 2013Article
- Single-dose versus multiple-dose antibiotic prophylaxis for the surgical treatment of closed fractures.Acta orthopaedica · 2010Article
- [Perioperative antibiotic prophylaxis. Use in orthopaedics].Der Orthopade · 2006Review
- Extracts from "clinical evidence": hip fracture.BMJ (Clinical research ed.) · 2001Review
- Evidence based case report: managing an elderly patient with a fractured femur.BMJ (Clinical research ed.) · 2000Review
Corrections and comments
- Updated by
Authors and funding
2 authors at 2 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAntibiotic 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.
objectivesTo 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:
participantsAny patients with a hip or other closed long bone fracture undergoing surgery for internal fixation or replacement arthroplasty.
interventionsAny regimen of systemic antibiotic prophylaxis administered at the time of surgery. OUTCOME MEASURES: Wound infection (deep and superficial), urinary tract infection, respiratory tract infection, adverse effects of prophylaxis, economic evaluations. 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
resultsTwenty 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
conclusionsAntibiotic prophylaxis should be offered to those undergoing surgery for closed fracture fixation. On ethical grounds, further placebo controlled randomised trials of the effectiveness of antibiotic prophylaxis in closed fracture surgery are unlikely to be justified. Trials addressing the cost-effectiveness of different effective antibiotic regimens would need to be very large and may not be feasible.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.