Antibiotics and the postburn hypermetabolic response

Severe burn injury has been documented to significantly increase resting metabolic energy expenditure. This increase in metabolic rate appears to be possibly correlated with the degree of burn wound colonization and infection with bacteria. Prevention of such colonization and infection through the use of topical antimicrobial agents appears to decrease the metabolic alterations resulting from burn injury. These findings indicate that appropriate use of topical antibacterial agents may decrease the metabolic demands seen in burned patients. Burn-induced translocation of intestinal bacteria has also been hypothesized to contribute to the postburn hypermetabolic response. Attempts at preventing this entity in a burned guinea pig model through the use of selective decontamination of the digestive tract by the administration of enteral antibiotics have failed to demonstrate any measurable effect.