Hendrickson SA, et al. - Given the recommendation from national UK guidance for administering intravenous antibiotics within 1 h of injury in severe open tibial fractures, researchers here investigated the influence of time to antibiotics on the development of deep infection in severe open tibial fractures. They retrospectively reviewed adult acute Gustilo-Anderson 3B open tibial fractures managed at a single UK Major Trauma Centre over a 3-year period; this period covered a period before and after the regional ambulance service implemented a policy of offering prehospital intravenous antibiotics to open fractures in 2016. An assessment of 156 patients with 159 fractures was done. Outcomes suggest no association of time to administration of intravenous antibiotics with the occurrence of deep infection in such patients. A low deep infection rate (7.5%) was observed, which is possibly due to expedient, expert care delivered by a dedicated specialist orthoplastic team.