Antibiotic prophylaxis for preventing burn wound infection

摘要: Background Infection of burn wounds is a serious problem because it can delay healing, increase scarring and invasive infection may result in the death patient. Antibiotic prophylaxis one several interventions that prevent wound protect burned patient from infections. Objectives To assess effects antibiotic on rates infection. Search methods In January 2013 we searched Wounds Group Specialised Register; The Cochrane Central Register Controlled Trials (CENTRAL); Ovid MEDLINE; MEDLINE - In-Process & Other Non-Indexed Citations (2013); EMBASE; EBSCO CINAHL reference lists relevant articles. There were no restrictions with respect to language, date publication or study setting. Selection criteria All randomised controlled trials (RCTs) evaluated efficacy safety for prevention BWI. Quasi-randomised studies excluded. Data collection analysis Two review authors independently selected studies, assessed risk bias, extracted data. Risk ratio (RR) mean difference (MD) estimated dichotomous data continuous data, respectively. When sufficient numbers comparable RCTs available, pooled meta-analysis estimate combined effect. Main results This includes 36 (2117 participants); twenty six (72%) topical antibiotics, seven systemic antibiotics (four these administered perioperatively three upon hospital admission during routine treatment), two non absorbable local via airway. The 11 (645 participants) silver sulfadiazine meta analysis. was statistically significant associated compared dressings/skin substitute (OR = 1.87; 95% CI: 1.09 3.19, I2 0%). These at high, unclear, bias. Silver also significantly longer length stay (MD 2.11 days; 1.93 2.28). Systemic non-surgical patients (119 there evidence an effect infection. Systemic (trimethoprim-sulfamethoxazole) reduction pneumonia (only trial, 40 (RR 0.18; 0.05 0.72) but not sepsis (two 59 0.43; 0.12 1.61). Perioperative had any outcomes this review. Selective decontamination digestive tract non-absorbable all types (2 trials, 140 participants). Moreover, MRSA use plus cefotaxime placebo 2.22; 1.21 4.07). There mortality airway 30 participants). Authors' conclusions The conclusions are able draw regarding prophylactic people burns limited by volume quality existing research (largely small unclear high bias each comparison). largest suggests increased dressings skin substitutes; Currently other forms unclear. One reported incidence specific systematic regimen.