Comparing Pre-operative Single dose and Full Dose Antibiotic Therapy in Burned Patients Required Surgical Debridement

Document Type : Original Article (s)

Authors

1 Assistant Professor, Department of Surgery, School of Medicine, Birjand University of Medical Sciences, Birjand, Iran

2 Resident, Department of Anesthesiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.

Abstract

Background: In conventional methods of surgical debridement for deep burn wounds, application of pre and post-operative antibiotics is a routine prescription in many centers. But, recently some new ideas indicate that decreasing antibiotics prescription has the same or better clinical results. This study evaluates the role of antibiotics in the management of burn wound which require surgical debridement.Methods: In this clinical trial, 214 patients with deep (3rd degree and deep 2nd degree) burn and total body surface area (TBSA) between 35 to 50% were randomly divided in control (105 patients) and intervention (109 patients) groups. In intervention group, only a pre-operative single dose of ceftazidme was prescribed. But in control group, pre and post-operative antibiotics was administered for 7 days. Sign and symptom of infection and tissue culture were compared in 2 groups for detection of wound infection.Findings: The incidence of wound infection was 28% in intervention group and 26.5% in control group (P > 0.05). The other benefits of single dose pre-operative antibiotic therapy were decrease in antibiotic resistant germs, the cost, and the time for nursing care. Conclusion: In deep burn wounds with total body surface area of less than 50%, application of single dose pre-operative antibiotic do not increase the risk of infection and can also decrease the final cost, multi-drug resistant bacteria production, and spent time in nursing care. As a result of this investigation, single dose pre-operative ceftazidme is recommended for all burned patients with less than 50% of total body surface area.

Keywords

References

  1. Word Health Organization. Violence and injury prevention and disability: burns [Cited 2011 May 5]. Available from: URL:
  2. http://www.who.int/entity/violence_injury_prevention/publications/other_injury/en/burns_factsheet.pdf
  3. Ahuja RB, Bhattacharya S. Burns in the developing world and burn disasters. BMJ 2004; 329(7463): 447-9.
  4. Sharma BR, Singh VP, Bangar S, Gupta N. Septicemia: the principal killer of burns patients. Am J Infect Dis 200; 1(3): 132-8.
  5. Skinner A, Peat B. Burns treatment for children and adults: a study of initial burns first aid and hospital care. N Z Med J 2002; 115(1163): U199.
  6. Lee F, Wong P, Hill F, Burgner D, Taylor R. Evidence behind the WHO guidelines: hospital care for children: what is the role of prophylactic antibiotics in the management of burns? J Trop Pediatr 2009; 55(2): 73-7.
  7. Ergun O, Celik A, Ergun G, Ozok G. Prophylactic antibiotic use in pediatric burn units. Eur J Pediatr Surg 2004; 14(6): 422-6.
  8. Sheridan RL, Weber JM, Pasternack MS, Tompkins RG. Antibiotic prophylaxis for group A streptococcal burn wound infection is not necessary. J Trauma 2001; 51(2): 352-5.
  9. American Burn Association. Burn Incidence and Treatment in the US: 2007 Fact Sheet[Online] 2007. Available from: URL:
  10. http://www.ameriburn.org/resources_factsheet.php.
  11. Townsend CM, Beauchamp RD, Evers BM, Mattox KL. Sabiston Textbook of Surgery: The Biological Basis of Modern Practicsurgical Practice. 18th ed. Philadelphia: WB. Saunders; 2007.
  12. Mozingo DW, McManus AT, Kim SH, Pruitt BA, Jr. Incidence of bacteremia after burn wound manipulation in the early postburn period. J Trauma 1997; 42(6): 1006-10.
  13. Vostrugina K, Gudaviciene D, Vitkauskiene A. Bacteremias in patients with severe burn trauma. Medicina (Kaunas) 2006; 42(7): 576-9.
  14. Ressner RA, Murray CK, Griffith ME, Rasnake MS, Hospenthal DR, Wolf SE. Outcomes of bacteremia in burn patients involved in combat operations overseas. J Am Coll Surg 2008; 206(3): 439-44.
Journal of Isfahan Medical School
Volume 29, Issue 155 - Serial Number 155
September and October 2011
Pages 1406-1411

Files

History

  • Receive Date: 19 February 2011
  • Revise Date: 30 May 2024
  • Accept Date: 06 April 2022

Share

How to cite

Statistics