Antibiotic prophylaxis for preventing burn wound infection
Leticia A Barajas-Nava1, Jesús López-Alcalde, Marta Roqué i Figuls
1Iberoamerican Cochrane Centre, Institute of Biomedical Research (IIB Sant Pau), Barcelona, Spain. leticia.barajas@cochrane.es.
The Cochrane Database of Systematic Reviews
|June 7, 2013
Summary
Antibiotic prophylaxis for burn wounds shows mixed results. Topical silver sulfadiazine increased infection and hospital stay, while systemic antibiotics had no effect on burn wound infection but reduced pneumonia in one study.
Area of Science:
- Infectious Diseases
- Wound Care
- Clinical Trials
Background:
- Burn wound infections pose significant risks, delaying healing, increasing scarring, and potentially leading to fatal invasive infections.
- Antibiotic prophylaxis is a strategy to prevent burn wound infections and subsequent invasive complications.
Purpose of the Study:
- To evaluate the efficacy and safety of antibiotic prophylaxis in preventing burn wound infections (BWI).
Main Methods:
- Systematic review and meta-analysis of randomized controlled trials (RCTs).
- Searched multiple databases without language or date restrictions.
- Included 36 RCTs involving 2117 participants, assessing various antibiotic prophylaxis methods.
Main Results:
- Topical silver sulfadiazine significantly increased BWI rates and hospital stay compared to dressings/skin substitutes (11 trials, 645 participants).
- Systemic antibiotic prophylaxis showed no effect on BWI in non-surgical patients (3 trials, 119 participants).
- One study indicated systemic antibiotics reduced pneumonia but not sepsis.
Conclusions:
- Evidence quality is limited by small, biased studies.
- Topical silver sulfadiazine appears detrimental for burn wound infection and hospital stay.
- The impact of other antibiotic prophylaxis methods on BWI remains unclear.
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