Prophylactic Antibiotic Use in Pediatric Burn Units

Abstract

Prophylactic antibiotic use in childhood burns is controversial. The efficiency of antibiotic prophylaxis in 77 pediatric burn patients was evaluated. Forty-seven patients received prophylactic antibiotics (Group AP), while 30 patients received no prophylaxis (Group NP). Age, wound depth, day of admission, mechanism of burn injury, type of dressings were similar for both groups (p > 0.05). Wound infection rates were 21.3 % in Group AP and 16.7 % in Group NP (p > 0.05). S. aureus, Enterobacter spp., P. aeruginosa, and E. coli were the most common microorganisms. Patients with wound colonization and infection had a larger burned total body surface area (BTBSA) in both groups (p < 0.01). Eight patients had clinical sepsis. All but one of the septic patients were from Group AP. Associated infections of the upper and lower respiratory tract (16), urinary tract (7), and otitis media (2) were more common in Group AP. One patient died from sepsis in Group AP. Hospital stays were longer in Group AP (21.7 +/- 16.4 vs. 13.5 +/- 10 days; p < 0.05). Antibiotic prophylaxis in childhood burns does not reduce the rate of wound infection. Age, wound depth and BTBSA are not critical variables for prophylaxis. Reinforcing the use of culture-specific antibiotics for more beneficial and cost-effective results in the treatment of childhood burns is recommended.

Infecciones en los niños quemados: análisis epidemiológico y de los factores de riesgo

“…20,21 En el estudio llevado a cabo por Ergün y cols., 22 no se demostró que la profilaxis antibiótica sistémica fuera eficaz para prevenir la infección. Por el contrario, se relacionó con mayores tasas de infección, lo que coincide con lo observado en esta serie.…”

Bacteriological Profile and Antibacterial Sensitivity Patterns of Isolates among Burn Patients in Sulaimani City

“…The prevalence of MRSA is various in clinical samples of burn patients as the result of distribution of PantonValentine Leukocidin (PVL) gene of the bacteria, Staphylococcal Cassette Chromosome mec (SCCmec) types and antibiotic resistant genes of the MRSA isolates. The disruption of the normal skin barrier and the immune compromised status make burn an easy target for MRSA colonization [21]. Additionally, using various types of penicillin too much without changing and self uses of antibiotic randomly are risks for development of MRSA colonization in which supported by Branski, L.K., et al [22].…”

Characteristics of Burn Injury and Factors in Relation to Infection among Pediatric Patients

“…This is in contrast to other studies which are shown that a Pseudomonas bacterium was the most common pathogen in pediatric burn patients. 32,62,74 The incidence of P. aeruginosa infection in the pediatric burn wards may be due to the fact that this bacterium thrives in a moist environment, and its ability to resist killing by more of antimicrobials. The minimal nutritional requirements of Pseudomonas, its ability to grow in distilled water and its tolerance to a wide variety of physical conditions in which contribute to its ecological success and ultimately to its role as an effective opportunistic pathogen.…”