Antibiotikatherapie von Infektionen bei Verbrennungspatienten - Eine systematische Übersichtsarbeit

Translated title of the contribution: Antibiotic treatment of infections in burn patients - A systematic review

K. S. Houschyar, Christian Tapking, D. Duscher, C. Wallner, A. Sogorski, S. Rein, D. Pförringer, G. Reumuth, K. Weissenberg, G. Grieb, Ludwik Branski, F. Siemers, B. Behr, M. Lehnhardt

Research output: Contribution to journalReview article

Abstract

Background Due to the loss of the natural skin barrier function with reduced immune competence as a result of a plasma loss and the numerous intensive care interventions, burn patients are particularly at risk for infection. Study design systematic review Methods A systematic review of German and English literature between 1990 and 2018 analyzes the epidemiological and diagnostic aspects as well as the therapeutic use of antibiotics in infections of burn patients in clinical trials. Results A total number of 53 randomized controlled clinical trials met the inclusion criteria. Various types / forms of application of antibiotic prophylaxis in burn wounds were investigated: topically, systemically (generally), systemically (perioperatively), nonabsorbable antibiotics (=selective intestinal decontamination), locally (inhaled) and all forms of administration versus control. Early postburn prophylaxis was studied in low-severity patients (six studies) and severe burn patients (seven studies). Antimicrobial prophylaxis has shown no effectiveness in the prevention of toxic shock syndrome in low grade burns, but can be useful in patients with severe burns in need for mechanical ventilation. Perioperative prophylaxis has been studied in ten studies. Conclusion The benefit of long-term systemic antibiotic prophylaxis in the majority of burn patients is not evident. Mild infections in stable clinical conditions should be closely monitored, while in severe infections, international sepsis guidelines and the Tarragona principle are recommended.

Original languageGerman
Pages (from-to)111-118
Number of pages8
JournalHandchirurgie Mikrochirurgie Plastische Chirurgie
Volume51
Issue number2
DOIs
StatePublished - Jan 1 2019

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Anti-Bacterial Agents
Infection
Antibiotic Prophylaxis
Burns
Therapeutics
Literature
Decontamination
Therapeutic Uses
Critical Care
Septic Shock
Artificial Respiration
Mental Competency
Sepsis
Randomized Controlled Trials
Clinical Trials
Guidelines
Skin
Wounds and Injuries

Keywords

  • antibiotics
  • burn
  • infection

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Antibiotikatherapie von Infektionen bei Verbrennungspatienten - Eine systematische Übersichtsarbeit. / Houschyar, K. S.; Tapking, Christian; Duscher, D.; Wallner, C.; Sogorski, A.; Rein, S.; Pförringer, D.; Reumuth, G.; Weissenberg, K.; Grieb, G.; Branski, Ludwik; Siemers, F.; Behr, B.; Lehnhardt, M.

In: Handchirurgie Mikrochirurgie Plastische Chirurgie, Vol. 51, No. 2, 01.01.2019, p. 111-118.

Research output: Contribution to journalReview article

Houschyar, KS, Tapking, C, Duscher, D, Wallner, C, Sogorski, A, Rein, S, Pförringer, D, Reumuth, G, Weissenberg, K, Grieb, G, Branski, L, Siemers, F, Behr, B & Lehnhardt, M 2019, 'Antibiotikatherapie von Infektionen bei Verbrennungspatienten - Eine systematische Übersichtsarbeit', Handchirurgie Mikrochirurgie Plastische Chirurgie, vol. 51, no. 2, pp. 111-118. https://doi.org/10.1055/a-0802-8882
Houschyar, K. S. ; Tapking, Christian ; Duscher, D. ; Wallner, C. ; Sogorski, A. ; Rein, S. ; Pförringer, D. ; Reumuth, G. ; Weissenberg, K. ; Grieb, G. ; Branski, Ludwik ; Siemers, F. ; Behr, B. ; Lehnhardt, M. / Antibiotikatherapie von Infektionen bei Verbrennungspatienten - Eine systematische Übersichtsarbeit. In: Handchirurgie Mikrochirurgie Plastische Chirurgie. 2019 ; Vol. 51, No. 2. pp. 111-118.
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abstract = "Background Due to the loss of the natural skin barrier function with reduced immune competence as a result of a plasma loss and the numerous intensive care interventions, burn patients are particularly at risk for infection. Study design systematic review Methods A systematic review of German and English literature between 1990 and 2018 analyzes the epidemiological and diagnostic aspects as well as the therapeutic use of antibiotics in infections of burn patients in clinical trials. Results A total number of 53 randomized controlled clinical trials met the inclusion criteria. Various types / forms of application of antibiotic prophylaxis in burn wounds were investigated: topically, systemically (generally), systemically (perioperatively), nonabsorbable antibiotics (=selective intestinal decontamination), locally (inhaled) and all forms of administration versus control. Early postburn prophylaxis was studied in low-severity patients (six studies) and severe burn patients (seven studies). Antimicrobial prophylaxis has shown no effectiveness in the prevention of toxic shock syndrome in low grade burns, but can be useful in patients with severe burns in need for mechanical ventilation. Perioperative prophylaxis has been studied in ten studies. Conclusion The benefit of long-term systemic antibiotic prophylaxis in the majority of burn patients is not evident. Mild infections in stable clinical conditions should be closely monitored, while in severe infections, international sepsis guidelines and the Tarragona principle are recommended.",
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