Retrospective review of 214 deep postoperative infections in 211 patients after fracture fixation at a Level I trauma center (2006–2010), characterizing bacterial speciation and clinically relevant antibiotic resistance to inform empiric antibiotic selection.
When selecting empiric antibiotics for suspected postoperative fracture infection, assume MRSA is present in roughly one-third of cases and ensure vancomycin is included. For pelvic, acetabular, and proximal femur infections specifically — even closed fractures.
Add gram-negative coverage given the 63% GNR rate; an infection presenting within the first two weeks should heighten suspicion for GNR as the primary pathogen.
Retrospective review of 214 deep postoperative infections in 211 patients after fracture fixation at a Level I trauma center (2006–2010), characterizing bacterial speciation and clinically relevant antibiotic resistance to inform empiric antibiotic selection.
When selecting empiric antibiotics for suspected postoperative fracture infection, assume MRSA is present in roughly one-third of cases and ensure vancomycin is included. For pelvic, acetabular, and proximal femur infections specifically — even closed fractures.
Add gram-negative coverage given the 63% GNR rate; an infection presenting within the first two weeks should heighten suspicion for GNR as the primary pathogen.