An evaluation of the role of systemic antibiotic prophylaxis in the control of burn wound infection at the Lagos University Teaching Hospital

A prospective study was carried out on 61 patients to evaluate the role of systemic antibiotic prophylaxis in the control of burn wound infection. The patients were randomised into three groups: group I (n = 21) received ampicillin and cloxacillin; group 2 (n = 20) received erythromycin and genticin and a control group (n = 20) received no systemic chemo prophylaxis. The burn wounds were similarly managed. Wound colonisation was determined from surface wound swab cultures and wound infection was determined from wound biopsy cultures and histopathology. The colonisation time (days) for the groups was 2.90 +/- 0.92, 3.15 +/- 0.77 and 3.05 +/- 0.83 for groups I and 2 and the control, respectively. The commonest organism isolated from contaminated wounds was Staphylococcus aureus. Wound infection was established in 5.70 +/- 1.70, 5.75 +/- 1.62 and 5.6 +/- 1.90 days for group 1, group 2 and the control group, respectively. There was no significant difference between wound infection time of control and group I nor was there such difference between the control and group 2 (P > 0.05). The commonest organism infecting burn wounds in all the groups was Pseudomonas aeruginosa followed by S. aureus. There was however a significant difference between the treatment groups and the control (P < 0.05) with regard to the percentage of infected wounds that grew P aeruginosa, compared to those that grew S. aureus. It was concluded that systemic antibiotic prophylaxis is of no value in controlling burn wound sepsis, and might even favour the growth of P. aeruginosa in the burn wounds. (C) 2003 Elsevier Science Ltd and ISBI. All rights reserved.