Investigating the Relationship Between the Use of Antibiotic Prophylaxis on Changes in Blood Factors, Mortality, Incidence of Infection and Drug Resistance in Burn Patients

Abstract

Background & aim: The use of antibiotic prophylaxis in the treatment of burns is a controversial issue. Many specialists start antibiotic treatment after the patient is admitted to prevent infection, while in most cases, antibiotic use is not necessary. The aim of the present study was to determine the relationship between the use of antibiotic prophylaxis on mortality, infection and drug resistance in burn patients without sepsis symptoms admitted to Amir al-Momenin Burn Injury Hospital. Methods: The present analytical-cross-sectional study was conducted in 2020-2021 at Amir al-Momenin Burn Injury Hospital, Shiraz, Iran. 2982 patients were included in the study. Patients' information, results of bacterial culture and antibiotic resistance of isolated isolates were extracted from burn patients' registry system and health information system. Descriptive statistics and the collected data were presented in tabular form. Quantitative data were summarized as mean and standard deviation and qualitative data as frequency and percentage graphs. Statistical analysis was analyzed for the association of results using paired t-test and chi-square. The level of statistical significance in all tests was considered P≤0.05. Results: Antibiotic resistance in hospitalized patients with prophylaxis treatment was 54.30%. The rate of mortality and re-hospitalization of patients in patients with no antibiotic prophylaxis was zero; In addition, the blood, liver and kidney factors of the patients were within the normal range. There was no significant difference between platelet levels, alkaline phosphatase serum level, alanine aminotransferase, blood urea nitrogen level and its ratio to creatinine (P≥0.05) on the first day of hospitalization and at the time of discharge. On the other hand, there was a significant difference between the levels of white blood cells, neutrophils and albumin (P<0.001) in the first three days of hospitalization and the time of discharge. Conclusion: The use of prophylactic antibiotics had no effect in the treatment of burn diseases without infection, and in order to reduce microbial resistance, it is better to avoid unnecessary use of antibiotics in burn areas.

Keywords

• prophylactic antibiotics
• mortality
• wound infection