Prophylaxis against infection. Single-dose cefonicid compared with multiple-dose cefamandole.

Single- Versus Multiple-Dose Antibiotic Prophylaxis in the Surgical Treatment of Closed Fractures: A Meta-Analysis

“…A subsequent trial by the same group of authors compared a single dose of long-acting cefonicid (t ½ 3.5 hours) to multiple doses of cefamandole. 11 No difference was detected between the groups, suggesting that the significantly short half-life of cefamandole may preclude its use as an effective single-dose prophylactic agent.…”

“…A further 108 patients from the Buckley trial were excluded because they received only placebo interventions; therefore, the subsequent meta-analysis included 3,808 subjects. Three studies favored a single dose, 11,12,16 whereas 4 studies favored multiple doses of prophylaxis. 9,10,13,15 However, only 1 study within the 7 pooled trials reported a statistically significant result.…”

The Mark Coventry Award: Higher Tissue Concentrations of Vancomycin With Low-dose Intraosseous Regional Versus Systemic Prophylaxis in TKA

“…The critical period therefore when adequate antibiotic concentrations must be present in the tissues is from the time of incision to the time of closure, an outcome achieved in our study in both IORA groups. Moreover, a number of randomized controlled trials have shown no difference in infection rates between a single preoperative dose and continuing antibiotics for 24 hours [13,16], implying further doses after IORA may be unnecessary. We found tissue concentrations were three to seven times greater in the 250-mg IORA group than in the systemic group, and given the lower risk of toxicity with lower doses, we would recommend 250 mg as the IORA dose for vancomycin.…”

Single versus multiple doses of antibiotic prophylaxis in limb fracture surgery

“…The antibiotic regime and the specific procedures in which its use will be beneficial are not clearly documented . Some authors suggest using a single preoperative dose, whereas others have used multiple dosing prophylaxis . Some believe that antibiotic prophylaxis use is not justified in low‐energy closed fractures, but others recommend it for open reduction and internal fixation of all closed fractures…”