Antibiotic prophylaxis in the burn population: A review of articles addressing the usage of antibiotics among burn patients

Infection is a major cause of morbidity and mortality among individuals suffering from major burn injuries. It has been hypothesized that prophylactic administrations of antibiotics would help to reduce the incidence of wound infection and subsequent septic-related mortality within the burn population. However, critics argue that such treatment practices would lead to the development of multi-drug resistant pathogens, eliminating any potentially beneficial clinical application they may have. This literature review will determine if prophylactic antibiotic therapy is warranted in the burn unit patient population, to reduce the incidence of septic occurrences, or if the risk of developing drug-resistance outweigh its clinical benefit. Methods: PubMed and Google Scholar were utilized to search for articles evaluating the effectiveness of antibiotic prophylaxis in reducing septic occurrences within the burn population. Additional articles were obtained through scanning of the bibliographical contents of all selected articles. Non-article sources consulted for background information included medical textbooks, emedicine.com, and the American Burn Association official website. Results: A total of sixteen articles were selected for inclusion in this literature review. While no unequivocal relationship was established between prophylactic antibiotics and infection rates in five of the six articles, one article (a systemic review and meta-analysis) reported a reduction in all-cause septic-related mortality. Conclusions: There are discrepancies in reports of the efficacy of prophylactic antibiotic treatments in preventing infection in the severely burned. Most articles (with the exclusion of one) concluded that the prophylactic effect these antibiotics had on reducing wound infection and subsequent septic-related events was minimal or non-existent. Larger randomized controlled trials utilizing adequate study sizes will be needed, before the true efficacy that prophylactic antibiotic practices have in preventing or reducing infection in the severely burned population can be addressed.