Comparison of antibiotic beads and intravenous antibiotics in open fractures

This study compared the efficacy of antibiotic impregnated beads with conve ntional intravenous antibiotics in the treatment of open fractures. A rando mized prospective study was designed and conducted during a 29-month period , Sixty-seven patients with 75 open fractures were treated similarly, with the exception of the method of antibiotic administration, and were followed up for at least 1 year after injury. Infection occurred in two of 24 (8.3% ) fractures treated with antibiotic beads alone and in two of 38 (5.3%) fra ctures treated with conventional intravenous antibiotics. In an unanticipat ed nonrandomized third cohort group, patients received antibiotic beads and intravenous antibiotics administered for nonorthopaedic reasons or limb th reatening injury, or both, Two of 13 (15.4%) fractures in this, high risk g roup became infected, Infection ultimately resolved in all fractures treate d with antibiotic beads alone or antibiotic beads in conjunction with conve ntional intravenous antibiotics, This study was unable to achieve statistic al significance; however, the data suggest: antibiotic beads may be useful in preventing infection in open fractures. Thus, a larger multicenter rando mized prospective study of isolated open fractures, eliminating other varia bles, is justified.