Diagnosis
Cultures, often quantitative, to determine the cause of infection.
105/gram of tissue usually means infection.
Epidemiologic Risks
Getting a burn.
Microbiology
Depends on the extent and degree of burn, virtually anything can be a pathogen in dead, burned tissue.
MDRO and fungi are particular issues.
Empiric Therapy
Depends on the microbiology.
However, a recent meta-analysis (BMJ full text) suggests
- In burns patients systemic antibiotic prophylaxis given the first 4-14 days significantly reduces all-cause mortality by nearly a half; limited perioperative prophylaxis reduces wound infections but not mortality.
- Topical antibiotic prophylaxis applied to burn wounds had no beneficial effects.
Pearls
Honey is better than antibiotic cream for minor burns for preventing infections and decreasing scar formation.
Rants
Last Update: 05/27/18.