الفهرس 
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Abstract
Background: A Surgical Site Infections (Ssis) Are Of Great Concern For Closed Orthopedic Surgeries. Proper Administration Of Prophylactic Antibiotics Operations May Reduce The Incidence Of Ssis But Its Practice In Egypt Remained Unexplored.
Objectives: This Study Composed Of 2 Parts; The First Aimed To Investigate The Current Practice On Antibiotic Prophylaxis For Closed Fractures Surgeries And Ssis In Egypt And To Identify The Associations Between Surgeons’ characteristics And The Antibiotic Prophylaxis. While The Second Aimed To Compare The Efficacy And Safety Of Cephalosporin Prophylaxis For Patients Undergoing Closed Fracture Surgeries.
Method: For The First Part: A Cross-Sectional Survey Was Conducted In Orthopedic Surgeons Using A Structured Questionnaire. For The Second Part: Eligible Patients Were Randomly Allocated To A Single-Blinded, Controlled Trial With Three Arms (Cefazolin As A Standard Control, Cefuroxime, And Cefotaxime). Patients’ Data Was Recorded Before And After Surgery. All Data Were Gathered And Analyzed Using Descriptive And Inferential Statistics.
Results: Ninety Four Orthopedic Surgeons Completed The Questionnaire With Response Rate 67.1%. Of These, About One Fourth Used Cefazolin And Began The Antibiotic Infusion Within 1 Hour Pre-Incision But All Of Them Continued The Prophylaxis For Minimum 2 Days Postoperative. The Surgeons’ characteristics Were Significantly Associated With The Prophylaxis As Specified (P = 0.001 To 0.047). The Comparative Trail Showed That 40 Patients Of Each group Participated In The Trial With Mean Age Of 41.9 Years (SD=16.5), 59.2% Of Them Were Male. All Baseline Data Were Not Different Across Three Groups, Except Few Trivial Factors. For Preventive Outcomes, Roughly 2 Patients With Ssis Were Found In Each Group; It Was Statistically Different (RR Of Cefuroxime 1.00, 95% CI 0.15-6.76; RR Of Cefotaxime 1.50, 95% CI 0.27-8.50). Patients Stayed In The Hospital Within Three Days With Marginal Readmission. Nausea And Vomiting And Urinary Tract Infection Were Reported.
Conclusion: The Low Adherence Of Orthopedic Surgeons To The Guideline Recommendations Were Attributed To Their Experiences And Warranted The Needs For An Awareness Program And The 3 Cephalosporins Cefotaxime Showed The Same Prophylactic Efficacy And Safety For Closed Fracture Surgeries But A Large-Scale Trial Is Required To Further Confirm The Preoperative Prophylaxis Of Cephalosporins.