Burns injury in children: Is antibiotic prophylaxis recommended?

Chahed, J.; Ksia, Amine; Selmi, Wieme; Hidouri, S.; Sahnoun, Lassâad; Krichène, I.; Mekki, Mongi; Nouri, Abdellatif

doi:10.4103/0189-6725.143141

Cited by 15 publications

(18 citation statements)

References 12 publications

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“…Ramos et al stated that antibiotic treatment is ineffective in patients with low‐ to mild‐degree burns, whereas it may be effective in the patients on a mechanical ventilator with high‐degree burns . A study conducted by Chahed et al revealed an infection ratio of 20% in the group prophylactically treated with amoxicillin/clavulanic acid and 15% in those treated with oxacillin . Even though the patients in our study were not provided prophylactic antibiotherapy, growth was noted in 14% of the cultures, thereby raising the question whether prophylactic antibiotherapy is indeed warranted.…”

Section: Discussioncontrasting

confidence: 52%

Sociodemographic and culture results of paediatric burns

Asena

Öztürk

2019

International Wound Journal

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Paediatric burn wounds are challenging conditions to manage for both the doctors and patients and can cause several complications entailing a complicated treatment and recovery process. This study aims to evaluate sociodemographic conditions and antibiogram culture results of paediatric burn wounds. Our study retrospectively evaluated 419 paediatric patients with burns regarding age, gender, burn area and degree, total days spent in hospital, surgical history, final condition, additional disease history, previous attempts, and culture results with their antibiotic resistances, haemogram results, C-reactive protein results, sociocultural conditions, burned region of the body, and structure of the burn. The prominent observations were an increased rate of incidence in male patients and patients with low socioeconomic conditions, the highest incidence of burns from scalding and domestic accidents, and the highest incidence of third-degree burns. Furthermore, even though the most encountered burn types were extremity burns, the burn types with the highest culture growth ratio were the perineum burns. The dominant culture growth bacterial group was coagulase-negative staphylococcus, and the ratio of medication resistance was 67.8%. It is imperative to raise awareness regarding domestic accidents to prevent paediatric burn wounds. The mortality risk can be reduced by carefully monitoring multiple organ involvement and providing timely treatment. Moreover, appropriate wound care is warranted to avoid infection from skin flora.

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Section: Discussioncontrasting

confidence: 52%

Sociodemographic and culture results of paediatric burns

Asena

Öztürk

2019

International Wound Journal

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“…Our study also showed the same tendency, that is, dominance of gram-positive infections in children with burns. Two different studies from Tunisia reported that the most common isolated microorganisms were methicillin-sensitive S. aureus (57.7%) and S. aureus (36.3%) in children with burns [14,15]. Moreover, Gang et al reported that 74% of patients with sepsis had bacteremia due to Staphylococcus species [16].…”

Section: Discussionmentioning

confidence: 96%

Burn-associated bloodstream infections in pediatric burn patients: Time distribution of etiologic agents

Devrim

Kara

Düzgöl

et al. 2017

Burns

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“…Unlike in the first forest plot (Fig 2), where systemic and local complications were distinguished from each other, in the remaining part of our meta-analysis we considered all (i.e., both local and systemic) complications together as the outcome. Using the combined rate of complications allowed us to include two studies in the analysis, in which the separate event rates of local and systemic complications were not reported [29, 32]. Merging the rates of local and systemic complications looked rational, for we did not find a significant difference in the OR between systemic and local complications (Fig 2).…”

Section: Resultsmentioning

confidence: 99%

“…After removing duplicates, 349 articles remained, which were screened on title and abstract for inclusion criteria. Full texts of 41 articles were reviewed and, in the end, 6 publications were found eligible for statistical analysis [18, 29–33], which included data from a total of 1,735 patients. The descriptive characteristics of these studies are shown in Table D in S1 File.…”

Section: Resultsmentioning

confidence: 99%

Systemic antibiotic prophylaxis does not affect infectious complications in pediatric burn injury: A meta-analysis

et al. 2019

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In pediatric burns the use of systemic antibiotic prophylaxis is a standard procedure in some burn centers, though its beneficial effect on the infectious complications is debated. The present meta-analysis aimed at determining whether systemic antibiotic prophylaxis prevents infectious complications in pediatric patients with burn injuries. We searched the PubMed, EMBASE, and Cochrane Library databases from inception to August 2019. We included 6 studies, in which event rates of infectious complications were reported in children with burn injuries receiving or not receiving systemic antibiotic prophylaxis. We found that the overall odds ratio (OR) of developing an infection (including local and systemic) was not different between the groups (OR = 1.35; 95% CI, 0.44, 4.18). The chances for systemic infectious complications alone were also not different between antibiotic-treated and non-treated patients (OR = 0.74; 95% CI, 0.38, 1.45). Based on the age, affected total body surface area, and country income level, we did not find any subgroup that benefited from the prophylaxis. Our findings provide quantitative evidence for the inefficacy of systemic antibiotic prophylaxis in preventing infections in pediatric burns. To validate our conclusion, multinational, randomized trials in a diverse population of children with burn injuries are warranted.

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Burns injury in children: Is antibiotic prophylaxis recommended?

Abstract: It is concluded that adequate and careful nursing of burn wounds seems to be sufficient to prevent complications and to obtain cicatrisation. Antibiotics are indicated only to treat confirmed infections.

Cited by 15 publications

References 12 publications

Sociodemographic and culture results of paediatric burns

Sociodemographic and culture results of paediatric burns

Burn-associated bloodstream infections in pediatric burn patients: Time distribution of etiologic agents

Systemic antibiotic prophylaxis does not affect infectious complications in pediatric burn injury: A meta-analysis

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