{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T00:02:17Z","timestamp":1779840137464,"version":"3.53.1"},"reference-count":24,"publisher":"Georg Thieme Verlag KG","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Z Orthop Unfall"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Open fractures are severe injuries in which bone is exposed due to soft tissue damage or skin perforation. They account for approximately 3% of all fractures, with a high prevalence in the tibia (around 25%). In addition to significant functional and psychological burden, they carry a high risk of infection, particularly osteomyelitis. Due to the compromised soft tissue barrier, preemptive antibiotic prophylaxis plays a key role.Inadequate treatment duration carries risks: if this is too short, it prevents complete eradication of pathogens, while if too long this increases adverse effects and the development of resistance. In order to develop recommendations, a systematic PubMed search (last five years) was conducted, which identified 82 relevant studies.Antibiotic therapy is essential in open fractures, as the disrupted skin barrier substantially increases infection risk. Critical factors include drug selection, timing, and duration. Administration should begin\n      immediately after trauma, ideally within 3\u00a0h.For Gustilo-Anderson type I\/II fractures, a single dose of a cephalosporin (e.g., cefuroxime) is generally sufficient. In cases of allergy, clindamycin is recommended; for MRSA carriers, vancomycin is indicated.Type III fractures require therapy of up to 72\u00a0h but not longer than 24\u00a0h after wound closure. The standard regimen is a combination of a cephalosporin with gentamicin; alternatively, piperacillin\/tazobactam may be used. In penicillin allergy, gentamicin or tobramycin is indicated.Thus, preemptive antibiotic therapy significantly reduces the risk of infection and is an essential component of open fracture management.<\/jats:p>","DOI":"10.1055\/a-2861-4981","type":"journal-article","created":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T23:04:51Z","timestamp":1779836691000},"source":"Crossref","is-referenced-by-count":0,"title":["Preemptive Antibiotic Administration in Open Fractures"],"prefix":"10.1055","author":[{"given":"Soufian","family":"Ben Amar","sequence":"additional","affiliation":[{"name":"University Hospital Bonn, Nordrhein-Westfalen, Germany","place":["Bonn"],"department":["Clinic for Orthopedics and Trauma Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8843-4695","authenticated-orcid":false,"given":"Jonas","family":"Roos","sequence":"additional","affiliation":[{"name":"University Hospital Bonn, Nordrhein-Westfalen, Germany","place":["Bonn"],"department":["Clinic for Orthopedics and Trauma Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9904-3443","authenticated-orcid":false,"given":"Alberto Alfieri","family":"Zellner","sequence":"additional","affiliation":[{"name":"University Hospital Bonn, Nordrhein-Westfalen, Germany","place":["Bonn"],"department":["Clinic for Orthopedics and Trauma Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristian","family":"Welle","sequence":"additional","affiliation":[{"name":"University Hospital Bonn, Nordrhein-Westfalen, Germany","place":["Bonn"],"department":["Clinic for Orthopedics and Trauma Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dieter Christian","family":"Wirtz","sequence":"additional","affiliation":[{"name":"University Hospital Bonn, Nordrhein-Westfalen, Germany","place":["Bonn"],"department":["Clinic for Orthopedics and Trauma Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Prangenberg","sequence":"additional","affiliation":[{"name":"Universit\u00e4tsklinikum Bonn, Germany","place":["Bonn"],"department":["Klinik und Poliklinik f\u00fcr Orthop\u00e4die und Unfallchirurgie, Hand- und Plastisch-Rekonstruktive Unfallchirurgie"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank Sebastian","family":"Fr\u00f6schen","sequence":"additional","affiliation":[{"name":"University Hospital Bonn, Nordrhein-Westfalen, Germany","place":["Bonn"],"department":["Clinic for Orthopedics and Trauma Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gunnar T","family":"Hischebeth","sequence":"additional","affiliation":[{"name":"Universit\u00e4tsklinikum Bonn, Germany","place":["Bonn"],"department":["Institut f\u00fcr medizinische Mikrobiologie, Immunologie und Parasitologie"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,5,26]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"399","DOI":"10.2174\/1874325001408010399","article-title":"The ortho-plastic approach to soft tissue management in trauma","volume":"8","author":"DJ Jordan","year":"2014","journal-title":"Open Orthop J"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"529","DOI":"10.1016\/s0020-1383(98)00125-9","article-title":"The epidemiology of open long bone fractures","volume":"29","author":"CM Court-Brown","year":"1998","journal-title":"Injury"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"631","DOI":"10.3928\/0147-7447-19950701-09","article-title":"Compartment pressure monitoring during intramedullary fixation of tibial fractures","volume":"18","author":"HD Moehring","year":"1995","journal-title":"Orthopedics"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"679","DOI":"10.1007\/s00132-020-03952-2","article-title":"Pr\u00e4vention von Infektionen nach offenen Frakturen","volume":"49","author":"T Maleitzke","year":"2020","journal-title":"Orthop\u00e4de"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"453","DOI":"10.2106\/00004623-197658040-00004","article-title":"Prevention of infection in the treatment of one thousand and twenty-five open fractures of long bones: retrospective and prospective analyses","volume":"58","author":"RB Gustilo","year":"1976","journal-title":"J Bone Joint Surg Am"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"3270","DOI":"10.1007\/s11999-012-2376-6","article-title":"In brief: Gustilo-Anderson classification. [corrected]","volume":"470","author":"PH Kim","year":"2012","journal-title":"Clin Orthop Relat Res"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"707","DOI":"10.1007\/s00113-022-01200-0","article-title":"Antibiotikaeinsatz zu Prophylaxe und empirischer Therapie von frakturassoziierten Infektionen in Deutschland","volume":"126","author":"S B\u00e4rtl","year":"2023","journal-title":"Unfallchirurgie (Heidelb)"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"7","DOI":"10.2147\/OAEM.S11862","article-title":"Antimicrobial prophylaxis in open lower extremity fractures","volume":"3","author":"A Anderson","year":"2011","journal-title":"Open Access Emerg Med"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"1056","DOI":"10.4414\/smf.2023.09299","article-title":"Antibiotikaprophylaxe\/pr\u00e4emptive Therapie bei offenen Frakturen in der Orthop\u00e4die","volume":"23","author":"I U\u00e7kay","year":"2023","journal-title":"Swiss Medical Forum"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"333","DOI":"10.1001\/archsurg.1988.01400270067010","article-title":"Duration of preventive antibiotic administration for open extremity fractures","volume":"123","author":"EP Dellinger","year":"1988","journal-title":"Arch Surg"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"532","DOI":"10.2106\/00004623-197456030-00010","article-title":", Ivler D. 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