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Looking at 140 patients retrospectively who had abdominal gunshot wounds with associated fractures, prophylactic antibiotics longer than three days did not offer any benefit in preventing fracture infection. Only two patients experienced fracture related infections and 65 total experienced any infection related complications.
From and ED standpoint, it appears reasonable to give a dose of antibiotics in this very rare subset of gunshot wound patients.
References
Kahler D, DeWitte N, Thompson M, Rehman S, Anderson J. Prophylactic antibiotics in gunshot fractures with concomitant bowel injury to prevent fracture-related infections and other infectious complications. Injury. 2025 Jun;56(6):112304. doi: 10.1016/j.injury.2025.112304. Epub 2025 Apr 8. PMID: 40279804.