Antibiotic Prophylaxis in Burn Patients: A Review of Current Trends and Recommendations for Treatment

Abstract

As nosocomial infections in burn patients are prevalent and dangerous, systemic antibiotic prophylaxis has been considered, beside other interventions. However, this kind of therapy has been questioned due to controversy related to its effectiveness and complications, such as drug toxicity and development of multidrug-resistance. This review includes evidence reported during the period 1966-2016. The quality of evidence and strength of recommendation of these guidelines are based on the GRADE system. Early post-burn prophylaxis showed no effectiveness for toxic shock syndrome or burn wound infection prevention (Grade 1C) in non-severe burn patients but it could be useful for those who had severe burns and require mechanical ventilation (Grade 2B). Perioperative prophylaxis would neither have indications for wound cleaning nor for devitalized tissue debridement of most burn patients (Grade 2B), but there is not enough evidence to make a strong recommendation to those who have extensive burns. Finally, prophylaxis could be used to prevent skin graft infections in selected procedures (Grade 2B).