COMPARISON OF INTRAVENOUS AND ORAL ANTIBIOTIC-THERAPY IN THE TREATMENT OF FRACTURES CAUSED BY LOW-VELOCITY GUNSHOTS - A PROSPECTIVE, RANDOMIZED STUDY OF INFECTION-RATES

One hundred and ninety consecutive patients (222 fractures) who had an extra-articular fracture of a long bone as a result of a low-velocity gunshot were randomized into two groups on the basis of the method of administration of antibiotics. Group 1 consisted of 101 patients (120 fractures) who were managed with intravenous administration of cephap irin sodium and gentamicin for three days. Group 2 comprised eighty-ni ne patients (102 fractures) who were managed with oral administration of ciprofloxacin for three days. The two groups were comparable in ter ms of the age of the patient, the locations of the fractures, and the time from the injury to the commencement of antibiotic therapy. Injuri es that needed operative debridement or fixation were excluded. All pa tients were followed until the fracture had healed. Two infections dev eloped in two of the ninety-nine patients (118 fractures) who complete d the study in Group 1, and two infections developed in two of the eig hty-seven patients (100 fractures) who completed the study in Group 2, With the numbers available, there was no significant difference in th e rates of infection (2 per cent for both) between the two groups. All four fractures that were complicated by infection were located in the distal half of the tibia. We concluded that oral and intravenous admi nistration of antibiotics were equally effective for prophylaxis again st infection after an extra-articular fracture from a low-velocity gun shot.