Open, appendicular fractures are often colonized with pathogenic bacteria at the time of definitive surgical debridement in dogs and cats.

Empiric open fracture antibiotics in dogs/cats should cover gram-negative aerobes.

This retrospective study analyzed bacterial colonization in open appendicular fractures in dogs and cats presented to a veterinary referral center between 2019-2024. Of 466 transferred fracture cases, 55 open fractures were identified (44 dogs, 11 cats), with 38 cases including culture results. Bacterial cultures were positive in 50% of fractures, yielding 42 pathogenic bacterial isolates from 15 genera. Enterobacterales (n=22) and Enterococcus species (n=9) were most frequently isolated. Notably, gram-negative aerobes were more prevalent in veterinary patients compared to human medicine literature. The overall complication rate was 47%, including minor, major, and catastrophic complications. Empiric antibiotic therapy should target both gram-positive and gram-negative aerobes, as monotherapy with penicillins or cephalosporins may provide inadequate coverage due to resistance patterns. The study suggests that veterinary open fracture management requires broader-spectrum antimicrobial considerations than traditional recommendations.

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