Randomized Trialhigh evidence
Intrawound Tobramycin Plus Vancomycin to Prevent Surgical Site Infection in Tibial Fractures: The TOBRA Randomized Clinical Trial.
JAMA·May 12, 2026·PMID 41984450
Why it mattersIntrawound vancomycin powder is commonly used to prevent infection in high-risk tibial fractures. This large, multicenter trial clarifies that adding tobramycin offers no additional benefit, helping surgeons avoid unnecessary antibiotic exposure and cost.
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