Year: 2026 | Month: October | Volume: 13 | Issue: 10 | Pages: 465-475
DOI: https://doi.org/10.52403/ijrr.20261042
Antibiotic Prophylaxis in Closed Fractures: A Systematic Literature Review
Thomas Erwin Christian Junus Huwae1, Syaifullah Asmiragani1, Agung Riyanto Budi Santoso1, Andhika Yudistira1, Ery Satriawan1
1Department of Orthopaedic and Traumatology, Faculty of Medicine, Universitas Brawijaya – Dr. Saiful Anwar General Hospital, Malang, Indonesia
Corresponding Author: Thomas Erwin Christian Junus Huwae
ABSTRACT
Introduction: Surgical site infection remains an important complication following surgical fixation of closed fractures. This systematic literature review aimed to summarize the types of prophylactic antibiotics used and their administration protocols in patients with closed fractures.
Methods: PubMed, Google Scholar, and Semantic Scholar were searched for studies published from 2019 to 2023 using the terms “closed fracture,” “infection,” and “antibiotic prophylaxis.” Eligible studies included patients with closed fractures who received prophylactic antibiotics and reported postoperative infection outcomes. Data were synthesized descriptively.
Results: Five studies involving 650 patients met the inclusion criteria. Prophylactic regimens varied in antibiotic selection, dosage, timing, dosing interval, and duration. Cefazolin and cefazedone were the most commonly used first-generation cephalosporins, while cefuroxime and cefotaxime represented second- and third-generation cephalosporins, respectively. All antibiotics were administered intravenously, generally 30–60 minutes before incision. Prophylaxis ranged from a single dose to repeated administration for up to 3 days, although most studies limited administration to 24 hours or less.
Conclusion: Cephalosporins were the predominant prophylactic antibiotics used in closed-fracture surgery, particularly first-generation agents. Although regimens varied across studies, intravenous administration before incision and prophylaxis of 24 hours or less were the most commonly reported approaches.
Keywords: antibiotic prophylaxis; cephalosporins; fractures, closed; surgical wound infection.
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