The Role of Early Antibiotic Administration in Reducing Surgical Site Infections in Open Fracture Trauma Patients

Wei Zhang

The Sixth People's Hospital of Shanghai Jiao Tong University School of Medicine, Shanghai, China

Leng Fei

Beijing Children's Hospital, Capital Medical University, Beijing, China

Siti Nurfatimah Mohd Shahpudin

sitinurfatimah.ms@usm.my

Department of Biomedical Sciences, Advanced Medical and Dental Institute, Universiti Sains Malaysia

Address correspondence to

Siti Nurfatimah Mohd Shahpudin, Department of Biomedical Sciences, Advanced Medical and Dental Institute, Universiti Sains Malaysia. Email:sitinurfatimah.ms@usm.my

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The Role of Early Antibiotic Administration in Reducing Surgical Site Infections in Open Fracture Trauma Patients

Wei Zhang

The Sixth People's Hospital of Shanghai Jiao Tong University School of Medicine, Shanghai, China

Leng Fei

Beijing Children's Hospital, Capital Medical University, Beijing, China

Siti Nurfatimah Mohd Shahpudin

sitinurfatimah.ms@usm.my

Department of Biomedical Sciences, Advanced Medical and Dental Institute, Universiti Sains Malaysia

Address correspondence to

Siti Nurfatimah Mohd Shahpudin, Department of Biomedical Sciences, Advanced Medical and Dental Institute, Universiti Sains Malaysia. Email:sitinurfatimah.ms@usm.my

2026 Mar;1(1):13-16

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Abstract

Objective: To determine the optimal timing of antibiotic administration and its impact on surgical site infection (SSI) rates in patients with open fractures. Methods: A retrospective cohort study was conducted involving 426 patients with grade I–III open fractures admitted to a Level 1 trauma center between January 2019 and December 2023. Patients were stratified into two groups based on the time from injury to first antibiotic dose: the early group (≤1 hour, n=218) and the delayed group (>1 hour, n=208). The primary outcome was the incidence of SSI within 30 days postoperatively. Secondary outcomes included the need for revision surgery, length of hospital stay, and 90 day mortality. Results: The early antibiotic group exhibited a significantly lower SSI rate (8.3% vs. 22.1%, P<0.001) compared to the delayed group. Patients in the early group also had a lower rate of revision surgery (5.5% vs. 14.4%, P<0.01), shorter hospital stay (12.4 ± 3.1 days vs. 18.7 ± 4.2 days, P<0.001), and comparable 90 day mortality (2.3% vs. 3.4%, P>0.05). Multivariate regression analysis identified delayed antibiotic administration (>1 hour) as an independent risk factor for SSI (OR=2.89, 95% CI=1.67–5.01, P<0.001). Conclusion: Administration of antibiotics within 1 hour of injury significantly reduces SSI rates and improves clinical outcomes in open fracture trauma patients, supporting current clinical guidelines advocating for prompt antibiotic prophylaxis in this population.

Keywords: Open fracture; Antibiotic prophylaxis; Surgical site infection; Trauma care; Clinical outcomes

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Journal of Contemporary Surgical Science

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Volume 1, Issue 1

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