Early infectious outcomes following addition of fluoroquinolone or aminoglycoside to post-trauma antibiotic prophylaxis in combat-related open fracture injuries.

Background: We examined combat-related open extremity fracture infections as a function of whether post-trauma antimicrobial prophylaxis included expanded Gram-negative (EGN) coverage. Methods: Military personnel with open extremity fractures sustained in Iraq and Afghanistan (2009-2014) who transferred to participating hospitals in the United States were assessed. The analysis was restricted to patients with a U.S. hospitalization period of >=7 days. Prophylaxis was classified as narrow (e.g., IV cefazolin, clindamycin, and/or amoxicillin-clavulanate) or EGN, if the prophylactic regimen included fluoroquinolones and/or aminoglycosides. Results: The study population included 1044 patients, of which 585 (56%) and 459 (44%) received narrow and EGN coverage, respectively (p

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