Assessment of 2 preventive antibiotic protocols in burned patients: retrospective and comparitive study between Fort de France (Martinique, FWI) and Lyon (France) - abstract

ABSTRACT

In a retrospective study, we performed two preventive antibiotic policies in 60 severly burned patients. All patients with a Burn Surface Area (BSA) of > 40 percent received ceftazidime-amikacin in Fort de France and piperacillin-netilmicin in Lyon. In Fort de France, 20 percent of patients developed septic shock with a mortality rate of 67 percent. Gram negative bacilli were always responsible for septic shock, of which 50 percent were resistant to initial antibiotics. In Fort de France, the bacteriological ecology in the burn centre showed less methicillin-resistant Staphylococcus aureus (MRSA) than the hospital (p < 0.05) and the same sensitivity for Pseudomonas aeruginosa. In Lyon, 37 percent of burn patients had septic shock with a mortality rate of 82 percent. In 91 percent, responsible isolates were multiresistant to initial antibiotics (p < 0.05). Bacteriological ecology of the burn centre was different from the hospital with a MRSA rate of 36.6 percent (p<0.02) and 54 percent of multiresistant Pseudomonas aeruginosa ( p < 0.05). Preventive antibiotics appear to be ineffective in severely ill burned patients. (AU)