CLINICAL EXPERIENCE WITH PROPHYLACTIC ANTIBIOTIC BOWEL SUPPRESSION IN BURN PATIENTS

  • 1 January 1978
    • journal article
    • research article
    • Vol. 83  (5) , 523-527
Abstract
An oral prophylactic antibiotic regimen (neomycin-erythromycin-nystatin) aimed at suppression of the bowel flora was utilized in 20 patients with thermal injury treated in a laminar flow burn unit with strict sterile technique and reverse isolation. The regimen was utilized for an average of 24 days. Surface cultures were obtained twice weekly from multiple areas of the burn wound and burn wound biopsies were performed 1-2 times weekly. These patients were compared prospectively with a group of 10 patients treated in otherwise identical fashion, save for the omission of the antibiotic suppressive regimen. Bacterial colonization of the burn wound occurred an average of 19 days after admission in the group receiving antibiotics compared to 4 days after admission in the control group (P < 0.01). Positive burn biopsies (> 105 bacteria/g of tissue) were observed twice as often in the group not receiving antibiotics (P < 0.16) as were infectious complications of several types: bacteremia, burn wound sepsis, urinary tract infections, pneumonitis, cellulitis (0.10 < P < 0.20). Staphylococcal or fungal overgrowth were not encountered in the patients receiving prophylactic antibiotics, nor was there an adverse effect on serum creatinine levels with the prolonged use of neomycin.

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