title: What should be the antibiotic prescription protocol for burn patients admitted in the department of burns, plastic and reconstructive surgery.
abstract: This is a prospective study with the aim to determine specific patterns of burn wound bacterial colonisation and antimicrobial resistance profiles. There is a high incidence of infections and septicaemia in post-burn patients, which, in turn, are associated with high morbidity and mortality, a fact that compelled us to undertake this study. The study was conducted over a period 11 months, from 1 August 2014 to 30 June 2015, in 50 burn patients admitted in our burn unit. Wound cultures were taken after 72 hours of admission from all the patients, and then, empirical systemic antibiotics were administered. For wound cultures; 1 cubic cm tissue was taken and placed in aerobic and anaerobic culture vials and transported to the microbiology lab under all aseptic precautions as soon as possible. At the time of fever any time after 72 hours of admission, 16 ml of blood was drawn under all aseptic precautions. Both aerobic and anaerobic blood culture vials were filled with 8 ml of blood each and transported to the microbiology lab. The results of culture and sensitivity reports of 50 patients were recorded. The data obtained was analysed using appropriate statistical analytical tests. The most common organism responsible for bacteraemia is Pseudomonas (43%). Most of the strains of organisms isolated were resistant to commonly used antibiotics in the hospital; Pseudomonas was found 100% resistant to a combination of ampicillin + sulbactum, ceftriaxone and was most often sensitive to imipenem, amikacin and vancomycin. Methicillin-resistant Staphylococcus aureus (MRSA) was also found resistant to commonly used antibiotics like ceftriaxone, ampicillin + sulbactum and ceftazidime + calvulanic acid. Linzolid and vancomycin were effective in 83% and 100% cases, respectively. We conclude that similar institution-specific studies should be conducted, and such studies will be helpful in providing useful guidelines for choosing effective empirical therapy that will have a great impact on the prevention of infection and its complications in burn patients because of bacteraemia.
authors.affiliation: Department of Burns, Plastic and Reconstructive Surgery, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, India.
authors.forename: Mohd Altaf
authors.initials: MA
authors.lastname: Mir
authors.affiliation: Department of Burns, Plastic and Reconstructive Surgery, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, India.
authors.forename: Mohammad Fahud
authors.initials: MF
authors.lastname: Khurram
authors.affiliation: Department of Burns, Plastic and Reconstructive Surgery, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, India.
authors.forename: Arshad Hafiz
authors.initials: AH
authors.lastname: Khan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D016470:Bacteremia / Q000188:drug therapy* / Q000209:etiology*; D002056:Burns / Q000150:complications* / Q000382:microbiology*; D024881:Drug Resistance, Bacterial; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects*; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D011446:Prospective Studies; D019651:Plastic Surgery Procedures / Q000379:methods; D013203:Staphylococcal Infections / Q000188:drug therapy*; D013518:Surgery, Plastic / Q000379:methods
chemical_list: D000900:Anti-Bacterial Agents
keywords: Antibiotic sensitivity; Bacteremia; Blood culture; Tissue culture