Topical antibiotic powder reduces fracture-related infections in pelvic and lower limb fractures: a systematic review and meta-analysis.

Study Summary

14 studies, including 3 randomized controlled trials (RCTs) and 11 observational studies involving 4906 patients undergoing surgical treatment for pelvic and lower limb fractures, were included in this systematic review and meta-analysis comparing topical antibiotic powder with standard systemic antibiotic prophylaxis. Pooled outcomes included fracture-related infection (FRI), superficial surgical site infection (SSI), fracture nonunion, acute kidney injury (AKI), length of hospital stay, and bacterial infection profiles. Topical antibiotic powder significantly reduced FRI, particularly in patients with open or high-risk fractures, without significantly affecting superficial SSI, nonunion, AKI, or hospital stay. However, Gram-negative infections were more frequently observed following topical antibiotic administration. These findings suggested that topical antibiotic powder provided additional protection against FRI, although further research was needed to establish its long-term safety and effects on bacterial resistance.