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Open Fracture Antibiotic Timing — FRCA Final MCQ

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EasyTrauma & Emergency AnaesthesiaOpen Fracture Antibiotic TimingFRCA Final

A 45-year-old man (80 kg) sustains a grade III open tibial fracture (Gustilo classification). In addition to surgical debridement and stabilisation, what is the recommended timing of IV antibiotic administration?

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Correct answer: D — Within 1 hour of injury

Open fractures require IV antibiotics as soon as possible, ideally within 1 hour of injury (NICE NG37, BOA/BAPRAS standards). Co-amoxiclav 1.2g IV is first-line (or a cephalosporin if penicillin-allergic). For Gustilo grade III injuries, gentamicin is added. Antibiotics should not be withheld pending wound cultures or until induction of anaesthesia – delay increases infection risk significantly. Antibiotic administration in the pre-hospital setting or emergency department is advocated.

Reference: NICE – 2020 – NG37 Fractures; BOA/BAPRAS – 2020 – Open fracture standards