Comparing Pre-operative Single dose and Full Dose Antibiotic Therapy in Burned Patients Required Surgical Debridement

In conventional methods of surgical debridement for deep burn wounds, application of pre and post-operative antibiotics is a routine prescription in many centers. But, recently some new ideas indicate that decreasing antibiotics prescription has the same or better clinical results. This study evaluates the role of antibiotics in the management of burn wound which require surgical debridement. In this clinical trial, 214 patients with deep (3rd degree and deep 2nd degree) burn and total body surface area (TBSA) between 35 to 50% were randomly divided in control (105 patients) and intervention (109 patients) groups. In intervention group, only a pre-operative single dose of ceftazidme was prescribed. But in control group, pre and post-operative antibiotics was administered for 7 days. Sign and symptom of infection and tissue culture were compared in 2 groups for detection of wound infection. The incidence of wound infection was 28% in intervention group and 26.5% in control group (P > 0.05). The other benefits of single dose pre-operative antibiotic therapy were decrease in antibiotic resistant germs, the cost, and the time for nursing care. In deep burn wounds with total body surface area of less than 50%, application of single dose pre-operative antibiotic do not increase the risk of infection and can also decrease the final cost, multi-drug resistant bacteria production, and spent time in nursing care. As a result of this investigation, single dose pre-operative ceftazidme is recommended for all burned patients with less than 50% of total body surface area.