Local Antibiotics and the Risk of Antimicrobial Resistance in Extremity Fractures Complicated by Fracture-Related Infection

A study examining antimicrobial resistance (AMR) patterns following local antibiotic use in patients with fractures from the PREP-IT study found no difference in AMR rates between those who received local antibiotic therapy with surgical fixation. The study included 546 patients and 268 fractures, with a higher injury severity score and proportion of open fractures among patients and fractures that received local antibiotics. The study also found that 1.7% of FRIs in fractures treated with local vancomycin had organisms resistant to vancomycin compared to 0.9% in fractures for which local vancomycin had not been used. The study concluded that there were no differences in AMR rates between fractures treated with or without local antibiotic prophylactic strategies, indicating the need for further prospective analysis.