Ecology of Bacteria Colonizing the Burned Patient Given Topical and Systemic Gentamicin Therapy: A Five-Year Study

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Abstract
Experience over a five-year period with 99 patients treated with gentamicin has been evaluated and the influence of this antibiotic upon invasive sepsis of burn wounds determined. The indications for systemic therapy were: established septicemia due to gram-negative bacteria, invasive sepsis of the burn wound, and resistant pulmonary and urinary infections. When a schedule of dosage of 3 mg/kg per 24 hr was maintained, no oto- or nephrotoxicity was demonstrated. While no resistance of gram-positive and gram-negative organisms developed, an alarming increase in the number of pathogenic yeasts, namely, Candida albicans, was noted. When the use of different chemotherapeutic regimens was rotated, gentamicin was noted to be an effective topical agent and permitted earlier closure of the burn wound than did mafenide (Sulfamylon), silver nitrate, or silver sulfadiazine. While bacterial resistance to gentamicin has been demonstrated in centers where gentamicin has been used exclusively for long periods of time, this experience shows that gentamicin is a safe and effective antibiotic for the treatment of sepsis of the bum wound, when administered for specific systemic and topical indications.

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