title: Randomized placebo-controlled trial of teicoplanin in the antibiotic prophylaxis of infection following manipulation of burn wounds.
abstract: BACKGROUND
  Burn wound surgery or change of dressings commonly causes bacteraemia. The use of antibiotic prophylaxis has not been tested adequately in a controlled trial.
  
  
  METHODS
  A randomized double-blind placebo-controlled study was performed to determine the effect on Gram-positive bacteraemia and clinical outcome of a single dose of teicoplanin (12 mg/kg intravenously) given at burns surgery or change of dressings.
  
  
  RESULTS
  A total of 134 patients were entered into the study, representing 220 episodes of dressing or debridement (110 episodes in each group). There was a significant difference between the groups with respect to perioperative Gram-positive bacteraemia: eight episodes (7 per cent) in the teicoplanin group versus 51 (46 per cent) in the placebo group (P < 0.001). However, good clinical outcome was similar in both groups (80 of 110 versus 77 of 110 respectively, P = 0.7). Only eleven patients had bacteraemia caused by Gram-negative species alone. Bacteriological response in terms of wound culture showed no significant difference between the groups: 63 (57 per cent) of 110 episodes versus 58 (53 per cent) of 110 respectively respectively.
  
  
  CONCLUSIONS
  Prevention of Gram-positive bacteraemia did not affect postoperative recovery.
authors.affiliation: Department of Clinical Microbiology, University College London Hospitals, UK.
authors.forename: J A
authors.initials: JA
authors.lastname: Steer
authors.forename: R P
authors.initials: RP
authors.lastname: Papini
authors.forename: A P
authors.initials: AP
authors.lastname: Wilson
authors.forename: D A
authors.initials: DA
authors.lastname: McGrouther
authors.forename: L S
authors.initials: LS
authors.lastname: Nakhla
authors.forename: N
authors.initials: N
authors.lastname: Parkhouse
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis / Q000009:adverse effects; D016470:Bacteremia / Q000517:prevention & control; D001424:Bacterial Infections / Q000517:prevention & control*; D002056:Burns / Q000382:microbiology / Q000601:surgery*; D004311:Double-Blind Method; D004352:Drug Resistance, Microbial; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017334:Teicoplanin / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D000900:Anti-Bacterial Agents; D017334:Teicoplanin