Template:Antibiotics Open Fracture
Revisión del 08:38 23 ene 2026 de Ostermayer (discusión | contribs.) (Created page with "===Antibióticos Profilácticos para Fracturas abiertas===")
Antibióticos Profilácticos para Fracturas abiertas
Iniciar lo más pronto posible; tasa de infección aumentada cuando se retrasa[1]
Opciones para Fracturas Grado I y II
- Cefazolin (Ancef) 2 g IV (inmediatamente y cada 8 horas x 3 dosis totales)[2]
- Alergia a cefalosporina: clindamicina 900 mg IV (inmediatamente y cada 8 horas x 3 dosis totales)[2]
Grade III Fracture Options
- Ceftriaxone 2 g IV (immediately x 1 total dose) PLUS vancomycin 1 g IV (immediately and q12 hours x 2 total doses)[2]
- Cephalosporin allergy: aztreonam 2 g IV (immediately and q8 hours x 3) PLUS vancomycin 1 g IV (immediately and q12 hours x 2 total doses)[2]
Special Considerations
- Concern for clostridium (soil contamination, farm injuries, possible bowel contamination): additionally add penicillin[3][2]
- Fresh water wounds: fluoroquinolones OR 3rd/4th generation cephalosporin
- Saltwater wounds (vibrio): doxycycline + ceftazidime OR fluoroquinolone
- ↑ Gosselin RA, et al. Antibiotics for preventing infection in open limb fractures. Cochrane Database Syst Rev. 2004; (1):CD003764.
- ↑ 2.0 2.1 2.2 2.3 2.4 Garner MR, et al. Antibiotic Prophylaxis in Open Fractures: Evidence, Evolving Issues, and Recommendations. Journal of the American Academy of Orthopaedic Surgeons. April 15, 2020. 28(8):309-315
- ↑ HoffWS, Bonadies JA, Cachecho R, Dorlac WC: East practice management guidelines work group: Update to practice management guidelines for prophylactic antibiotic use in open fractures. J Trauma 2011;70:751-754.