title: Burns injury in children: is antibiotic prophylaxis recommended?
abstract: BACKGROUND
  Wound infection is the most frequent complication in burn patients. There is a lack of guidelines on the use of systemic antibiotics in children to prevent this complication.
  
  
  METHODS
  A prospective study is carried out on 80 patients to evaluate the role of antibiotic prophylaxis in the control of infections.
  
  
  RESULTS
  The mean age was 34 months (9 months to 8 years). There was a male predominance with sex ratio of 1.66. The mean burn surface size burn was 26.5% with total burn surface area ranging from 5% to 33%, respectively. According to American Burn Association 37% (30/80) were severe burns with second and third degree burns >10% of the total surface body area in children aged <10 years old. Scalds represented 76.2% (61/80) of the burns. Burns by hot oil were 11 cases (13.7%), while 8 cases (10%) were flame burns. The random distribution of the groups was as follow: Group A (amoxicilline + clavulanic acid) = 25 cases, Group B (oxacilline) = 20 cases and Group C (no antibiotics) = 35 cases. Total infection rate was 20% (16/80), distributed as follow: 8 cases (50%) in Group C, 5 cases (31.2%) in Group A and 3 cases in Group B (18.7%). Infection rate in each individual group was: 22.9% (8 cases/35) in Group C, 20% (5 cases/25) in Group A and 15% (3 cases/20) in Group B (P = 0.7). They were distributed as follow: Septicaemia 12 cases/16 (75%), wound infection 4 cases/16 (25%). Bacteria isolated were with a decreasing order: Staphylococcus aureus (36.3%), Pseudomonas (27.2%), Escherichia coli (18.1%), Klebsiella (9%) and Enterobacteria (9%). There is a tendency to a delayed cicatrisation (P = 0.07) in case of hot oil burns (65.18 ± 120 days) than by flame (54.33 ± 19.8 days) than by hot water (29.55 ± 26.2 days). Otherwise no toxic shock syndrome was recorded in this study.
  
  
  CONCLUSIONS
  It is concluded that adequate and careful nursing of burn wounds seems to be sufficient to prevent complications and to obtain cicatrisation. Antibiotics are indicated only to treat confirmed infections.
authors.affiliation: Department of Pediatric Surgery, EPS Fattouma Bouguiba, Faculty of Medicine, Monastir, CP 5000, Tunisia.
authors.forename: Jamila
authors.initials: J
authors.lastname: Chahed
authors.forename: Amine
authors.initials: A
authors.lastname: Ksia
authors.forename: Wieme
authors.initials: W
authors.lastname: Selmi
authors.forename: Saida
authors.initials: S
authors.lastname: Hidouri
authors.forename: Lassaad
authors.initials: L
authors.lastname: Sahnoun
authors.forename: Imed
authors.initials: I
authors.lastname: Krichene
authors.forename: Mongi
authors.initials: M
authors.lastname: Mekki
authors.forename: Abdellatif
authors.initials: A
authors.lastname: Nouri
mesh_terms: D019072:Antibiotic Prophylaxis; D002056:Burns / Q000150:complications*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D011446:Prospective Studies; D016896:Treatment Outcome; D014416:Tunisia; D014946:Wound Infection / Q000382:microbiology* / Q000517:prevention & control*