Antibiotic therapy and infection complications in paediatric burn injuries

Abstract

Aim: Each year, nearly 1% of the population suffers from burn injuries. Infections are the main cause of complications and death after thermal injury. Excessive use of antibiotics affects the children treated for burns and can have negative effects. Therefore, specifying the recommendations for antibiotic therapy in patients after thermal injury seems to be of importance. Material/Methods: An evaluation of 310 paediatric patients hospitalized for burn injuries was performed. The first part of the evaluation consisted of a retrospective analysis of treatment with particular focus on infection complications and administered antibiotics. This was followed by a prospective evaluation of the effectiveness of the principles of antibiotic therapy specified at the earlier stage. Results: In 2010-2016, antibiotics were systemically administered to 53.4% of children treated for thermal injury, and in 87.1% of these cases it was introduced as a prophylactic measure. Infection of a burn wound was recorded in 4.7% of cases. The most frequently isolated bacterium (57.1%) was Staphylococcus aureus MSSA. Administration of antibiotics failed to reduce the number of infection complications or burn wound infections. The studies formed the basis for the specification of the internal antibiotic therapy criteria, the effectiveness of which was then evaluated. In 2017, an antibiotic was administered to 37.1% of patients. Reducing antibiotic therapy did not increase the risk of infection complications or the frequency of wound infections. Conclusions: Routine antibiotic prophylaxis in burn injuries has no effect on the risk of infection complications and does not reduce the treatment time. It should be limited to perioperative prophylaxis in the case of skin grafts and to the patients with progressing symptoms of burn disease or with concomitant infections.