Standard Versus Short Course Prophylactic Antibiotic in Femur and Tibia Shaft Fractures Managed with Intramedullary Interlocking Nail: A Pilot Study

Introduction: Intramedullary nailing remains the preferred treatment for most diaphyseal fractures of femur and tibia. However, surgical site infection and fracture related infection remain significant complication of nailing. Methods: This was a pilot, single-center, hospital-based comparative study among adult patients (≥18 years) with diaphyseal fractures of the femur or tibia treated surgically with intramedullary interlocking nail. They were divided into Group A (Standard course prophylaxis) versus Group B (Short-course prophylaxis). At two and six weeks, wounds were evaluated by a trained infection-control nurse using the ASEPSIS score. Results: There were 56 patients, (Group A: n = 24; Group B: n = 28) with the mean age of 34.62±12.83 years. Both the groups were comparable in demographic composition. Wound evaluation on the second week and at sixth week showed no statistically significant differences between the two groups based on antibiotic protocol and wound status (p=0.363). Conclusions: A short-course prophylactic antibiotic regimen is as efficient to as a standard three-day regimen for patients undergoing intramedullary nailing of closed femoral and tibial fractures.