Treatment of invasive Enterobacter cloacae burn wound sepsis with topical nitrofurazone

Nine patients with invasive Enterobacter cloacae burn wound sepsis were identified in a series of 400 admissions to our Burn Center. In vitro antibacterial testing of topical agents revealed sensitivity to nitrofurazone cream. Treatment of this series of patients with nitrofurazone resulted in an overall 66% survival compared with an 86% mortality reported in the literature. We recommend that topical antibacterial sensitivity testing be routinely performed in the microbiology laboratory for isolates from burn patients, and that nitrofurazone cream be included among the agents tested for effectiveness.