Role of Prophylactic Systemic Antibiotics In Acute Deep Dermal Burn Wounds Of 20%-40% TBSA - A Comparative Study In A Tertiary Burn Care Centre

Abstract

Introduction
Infection in the burn patient is a leading cause of morbidity and mortality. Strict aseptic measures, constant wound surveillance with regular sampling for culture growth, early excision and wound closure remain the principal adjuncts to control invasive infection in burn wounds. Numerous studies show prophylactic antibiotics has a role in prevention of burn wound infections in severe burns. There is a controversy as to whether prophylactic antibiotics have a role in burn wounds below 40% TBSA.
Materials & Method
100 patients presenting with acute deep dermal burns with 20-40% TBSA were randomly assigned to two groups in which one group received prophylactic antibiotic of Pipericillin and Tazobactum for 7 days and the other group did not receive any antibiotics. Physical examination of the wounds and wound swabs were taken at regular intervals to assess burn wound infection. Burns wounds were treated according to our burn unit protocol. The study ended when wound healing was complete or the patient developed an established wound infection.
Result
The mean age of the participants was 37 yrs, the average percentage of burn severity was 28.7%, incidence rate of burn wound infection in the antibiotic group was 37.5% and in the no-antibiotic group was 25%. Organisms isolated from burn wounds were Pseudomonas, Acinetobacter, E. coli, and Staphylococcus. The average hospital stay was 7.6 days. Statistical analysis showed no significant association between antibiotic usage and prevention of burn wound infection in acute deep dermal burns of 20-40% TBSA .
Conclusion
The study concluded that prophylactic systemic antibiotics have no beneficial role in preventing burn wound infection in 20-40%TBSA burns. though there is a need for randomized control trials to assess further.