Antibiotic therapy and infection complications in paediatric burn injuries

ORIGINAL ARTICLE

Antibiotic therapy and infection complications in paediatric burn injuries

Jakub Noskiewicz 1 , Paweł Juszczak 2 , Małgorzata Rzanny- Owczarzak 1 , Przemysław Mańkowski 1

1. Department of Paediatric Surgery, Traumatology and Urology, Poznan University of Medical Sciences, Poznań, Poland,
2. Department of Human Nutrition and Hygiene, Poznan University of Life Sciences, Poznań, Poland,

Published: 2019-05-15
DOI: 10.5604/01.3001.0013.2019
GICID: 01.3001.0013.2019
Available language versions: en pl
Issue: Postepy Hig Med Dosw 2019; 73 : 332-337

 

Abstract

Background: Each year, nearly 1% of population suffers from burn injuries. The main cause of complications and death after thermal injury is infections. Excessive use of antibiotics affects however 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. Materials and methods: An evaluation of 310 paediatric patients hospitalised for burn injuries was performed. In the first part of evaluation, a retrospective analysis of treatment with particular focus on infection complications and administered antibiotics was performed. This was followed by a prospective evaluation of effectiveness of the principles of antibiotic therapy specified at the earlier stage. Results: In 2010-2016, an antibiotic was systemically administered to 53.4% of children treated for thermal injury, provided that in 87.1% of 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. Supply of antibiotics failed to reduce the number of infection complications or burn wound infections. The studies formed the basis for specification of the internal antibiotic therapy criteria, 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 frequency of wound infections. Conclusion: 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.

References

  • 1. Chahed J., Ksia A., Selmi W., Hidouri S., Sahnoun L., Krichene I.,Mekki M., Nouri A.: Burns injury in children: is antibiotic prophylaxis recommended? Afr. J. Paediatr. Surg., 2014; 11(4): 323–5
    Google Scholar
  • 2. Collier Z.J., Gottlieb L.J., Alverdy J.C.: Stochasticity amongantibiotic-resistance profiles of common burn-related pathogensover a six-year period. Surg. Infect., 2017; 18: 327–35
    Google Scholar
  • 3. Davies A., Spickett-Jones F., Brock P., Coy K., Young A.: Variationsin guideline use and practice relating to diagnosis and managementof infection in paediatric burns services in England and Wales: A national survey. Burns, 2017; 43(1): 215–22
    Google Scholar
  • 4. DiMuzio E.E., Healy D.P., Durkee P., Neely A.N., Kagan R.J.:Trends in bacterial wound isolates and antimicrobial susceptibility in a pediatric burn hospital. J. Burn Care Res., 2014; 35(5):e304–311
    Google Scholar
  • 5. Ergün O., Celik A., Ergün G., Ozok G.: Prophylactic antibiotic usein pediatric burn units. Eur. J. Pediatr. Surg., 2004; 14(6): 422–6
    Google Scholar
  • 6. Fadeyibi I.O., Raji M.A., Ibrahim N.A., Ugburo A.O., Ademiluyi S.:Bacteriology of infected burn wounds in the burn wards of a teachinghospital in Southwest Nigeria. Burns, 2013; 39(1): 168–713
    Google Scholar
  • 7. Gang R.K., Sanyal S.C., Bang R.L., Mokaddas E., Lari A.R.: Staphylococcal septicaemia in burns. Burns, 2000; 26(4): 359–66
    Google Scholar
  • 8. Kim H.S., Yang H.T., Hur J., Chun W., Ju Y.S., Shin S.H., Kang H.J.,Lee K.M.: Procalcitonin levels within 48 hours after burn injury asa prognostic factor. Ann. Clin. Lab. Sci., 2012; 42(1): 57–64
    Google Scholar
  • 9. Lee F., Wong P., Hill F., Burgner D., Taylor R.: Role of prophylactic antibiotics in the management of burns? J. Trop. Pediatr., 2009; 55: 73–7
    Google Scholar
  • 10. Matuszczak E., Tylicka M., Dębek W., Hermanowicz A., OstrowskaH.: Correlation between circulating proteasome activity, total protein and c-reactive protein levels following burn in children. Burns,2014; 40(5): 842–7
    Google Scholar
  • 11. Ramirez-Blanco C.E., Ramirez-Rivero C.E., Diaz-Martinez L.A.,Sosa-Avila L.M.: Infection in burn patients in a referral center inColombia. Burns, 2017; 43(3): 642–53
    Google Scholar
  • 12. Ramos G., Resta M., Machare Delgado E., Durlach R., FernandezCanigia L., Benaim F.J.: Systemic perioperative antibiotic prophylaxismay improve skin autograft survival in patients with acute burns.Burn. Care. Res., 2008; 29(6): 917–23
    Google Scholar
  • 13. Rosanova M.T., Stamboulian D., Lede R.: Infections in burnedchildren: epidemiological analysis and risk factors. Arch. Argent.Pediatr., 2013; 111(4): 303–8
    Google Scholar
  • 14. Rosanova M.T., Tramonti N., Taicz M., Martiren S., Basílico H.,Signorelli C., Buchovsky A., Lede R.: Assessment of C-reactive proteinand procalcitonin levels to predict infection and mortality in burnchildren. Arch. Argent. Pediatr., 2015; 113(1): 36–41
    Google Scholar
  • 15. Sheridan R.L., Weber J.M., Pasternack M.S., Tompkins R.G.: Antibiotic prophylaxis for group A streptococcal burn wound infectionis not necessary. J. Trauma, 2001; 51(2): 352–5
    Google Scholar
  • 16. Yali G., Jing C., Chunjiang L., Cheng Z., Xiaoqiang L., Yizhi P.:Comparison of pathogens and antibiotic resistance of burn patientsin the burn ICU or in the common burn ward. Burns, 2014; 40(3):402–7
    Google Scholar

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