A level-II retrospective prognostic study of 137 patients with type III open tibia fractures found that those given antibiotics within 66 minutes of sustaining the injury were nearly four times less likely to develop a deep infection during a 90-day follow-up than those receiving antibiotics more than an hour after injury. This relatively short therapeutic window for antibiotic prophylaxis led study authors to conclude that “prehospital antibiotics may substantially improve outcomes for severe open fractures.” In an interview with Loyola Medicine, study co-author William Lack, MD encouraged further research into the safety and efficacy of allowing paramedics to administer antibiotics in such cases.
The study also found that patients whose wounds remained open beyond five days post-injury were more than seven times more likely to experience infections than those with earlier wound coverage, but the authors noted that time-to-wound-coverage is predominantly dependent on the condition of the wound.