Antibiotic therapy is a recognised standard of care in open fractures. The purpose of this study was to look into the consistency of pattern of antibiotic prescribing practice in the management of open fractures. Eighty children presenting with open tibial fractures between 1989 and 2009 were taken into this retrospective audit. The relevant information was collected from the case records. Patients were grouped into two groups, those who were treated before and those after the guidelines. Seventy-eight patients with complete records were included in this audit. 37 patients had Gustilo and Anderson Grade I, 24 had grade II and 17 had Grade III open fractures. First dose intravenous antibiotic was given in A and E department in 55 patients. Sixty four patients had cephalosporins and 24 patients had pencillins. In 7 patients additional metronidazole was given. Only intravenous therapy was given in 29 patients and intravenous therapy followed by oral antibiotics in 49 patients. Average duration of intravenous therapy for patients treated before 1997, was 2.9 days. Whereas those treated after 1997, had average intravenous therapy for 2.8 days. There is lack of consistency in use of prophylactic antibiotics in open fractures. This audit has prompted us a reevaluation of antibiotic therapy in open fractures to find a consistent regimen
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