{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T23:37:56Z","timestamp":1787009876202,"version":"build-2736575974"},"reference-count":47,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,6]]},"abstract":"\n OBJECTIVE:<\/jats:title>\n To compare rates of fracture-related infection (FRI) and acute kidney injury (AKI) in patients with open fractures treated with ceftriaxone (CTX) monotherapy or piperacillin\u2013tazobactam (PIP\u2013TAZ) monotherapy.<\/jats:p>\n <\/jats:sec>\n \n METHODS:<\/jats:title>\n <\/jats:sec>\n \n Design:<\/jats:title>\n Retrospective cohort study.<\/jats:p>\n <\/jats:sec>\n \n Setting:<\/jats:title>\n Single Level I Trauma Center (2020\u20132023).<\/jats:p>\n <\/jats:sec>\n \n Patient Selection Criteria:<\/jats:title>\n Adults who sustained an open fracture of the femur, tibia, humerus, radius\/ulna, and foot fractures (metatarsals, calcaneus, talus) and underwent operative irrigation and debridement. Exclusion criteria were less than 6 months of follow-up, hospital transfers, primary amputation, receipt of vancomycin within the first 48 hours in addition to CTX or PIP\u2013TAZ, and cases requiring vascular bypass, rotational or free flaps, or full-thickness skin grafts.<\/jats:p>\n <\/jats:sec>\n \n Outcome Measures and Comparisons:<\/jats:title>\n Primary outcomes were rates FRI and AKI. Outcomes were compared between patients receiving prophylactic CTX versus PIP\u2013TAZ monotherapy.<\/jats:p>\n <\/jats:sec>\n \n RESULTS:<\/jats:title>\n \n A total of 156 patients with open fractures were identified, of which 136 met inclusion criteria: 67 treated with CTX monotherapy and 69 with PIP\u2013TAZ monotherapy. The mean age was 46.2 years (range: 18\u201386) in the CTX cohort and 41.6 years (range: 19\u201383) in the PIP\u2013TAZ cohort, and males comprised 56.7% and 72.3% of each group, respectively. Differences between groups were limited to a longer mean follow-up duration in the PIP\u2013TAZ cohort (\n P<\/jats:italic>\n < 0.001) and a higher prevalence of soil contamination in the CTX cohort (11.9% vs. 1.4%,\n P<\/jats:italic>\n = 0.015). There were no statistically significant differences in rates of FRI (25.4% CTX vs. 29.0% PIP\u2013TAZ,\n P<\/jats:italic>\n = 0.501) or AKI (11.9% vs. 15.9%,\n P<\/jats:italic>\n = 0.636) between groups. On multivariate analysis, diabetes (OR 6.62,\n P<\/jats:italic>\n = 0.003) was independently associated with increased FRI risk, whereas soil contamination (OR 3.42,\n P<\/jats:italic>\n = 0.180) and external fixation (OR 1.92,\n P<\/jats:italic>\n = 0.163) demonstrated nonsignificant trends toward higher risk.\n <\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS:<\/jats:title>\n In this retrospective cohort of patients with open fractures, ceftriaxone and piperacillin\u2013tazobactam demonstrated comparable outcomes in both fracture-related infection and acute kidney injury. Diabetes was found to be a statistically significant risk factor for FRI.<\/jats:p>\n <\/jats:sec>\n \n LEVEL OF EVIDENCE:<\/jats:title>\n Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.<\/jats:p>\n <\/jats:sec>","DOI":"10.1097\/bot.0000000000003153","type":"journal-article","created":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T14:01:09Z","timestamp":1769695269000},"page":"294-299","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Ceftriaxone Versus Piperacillin\u2013Tazobactam Monotherapy for Open Fracture Prophylaxis: A Retrospective Cohort Study"],"prefix":"10.1097","volume":"40","author":[{"given":"A. Hampton","family":"Sisson","sequence":"first","affiliation":[{"name":"Heersink School of Medicine, University of Alabama at Birmingham; Birmingham, AL;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-9447-2857","authenticated-orcid":false,"given":"Robin M.","family":"Litten","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Alabama at Birmingham; Birmingham, AL; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan N.","family":"McIlwain","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Alabama at Birmingham; Birmingham, AL; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashley N.","family":"Kimbel","sequence":"additional","affiliation":[{"name":"Heersink School of Medicine, University of Alabama at Birmingham; Birmingham, AL;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doriann 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