The results indicate that antibiotic prophylaxis has no significant effect on mortality and clinical status compared with placebo or standard care in adult polytrauma patients but may reduce the risk of VAP.

However, the evidence is outdated and of very low certainty, with insufficient data to draw definitive conclusions regarding efficacy.

Therefore, high-quality, up-to-date research is urgently needed to support clinical decision-making, and current interpretations should be treated with caution.

Of 1237 identified records, three RCTs involving 256 patients (nantibiotics = 176, ncontrol = 165, mean age 37.4 years, 81.6% male) were included.

Antibiotic prophylaxis showed little or no effect on all-cause mortality compared to placebo or standard care (RR 1.01, 95% CI 0.55–1.85; RD 2 more per 1000, 95% CI -79 to 150; 2 studies, 209 participants; I2 = 0%; very low certainty of evidence).

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