Profilaxis antibiótica en quemaduras
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oct 3, 2011
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Resumen
Introducción. Las quemaduras son un importante problema de salud, en especial en los países en vía de desarrollo, y presentan múltiples condiciones de morbilidad con altos porcentajes de mortalidad por procesos infecciosos.
Desarrollo. Se hizo una búsqueda de la literatura médica disponible, con el objetivo de llegar a conclusiones acerca de la profilaxis antibiótica en el paciente con quemaduras.
Conclusiones. Los antibióticos profilácticos reducen todas las causas de mortalidad en pacientes de la unidad de cuidado intensivo y en pacientes con quemaduras; administrados en las primeras dos semanas, reducen la mortalidad cerca a la mitad. Infortunadamente, la información disponible es insuficiente y estas medidas no se pueden generalizar. La profilaxis perioperatoria reduce la infección de las áreas quemadas, pero no la mortalidad, y los antibióticos tópicos aplicados en las lesiones disminuyen las tasas de infección y colonización bacteriana en algunos grupos etarios. Es necesario aportar nuevos y sólidos datos.
Keywords
antibiotic prophylaxis, burns, infection, mortality, profilaxis antibiótica, quemaduras, infección, mortalidad,
References
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2. Sanghavi P, Bhalla K, Das V. Fire-related deaths in India in 2001: a retrospective analysis of data. Lancet. 2009;373:1282-8.
3. Chim H, Tan BH, Song C. Five-year review of infections in a burn intensive care unit: High incidence of Acinetobacter baumannii in a tropical climate. Burns. 2007;33:1008-14.
4. Wibbenmeyer L, Danks R, Faucher L, et al. Prospective analysis of nosocomial infection rates, antibiotic use, and patterns of resistance in a burn population. J Burn Care Res. 2006;27:152-60.
5. Brigham PA, McLoughlin E. Burn incidence and medical care use in the United States: Estimate, trends, and data sources. J Burn Care Rehabil. 1996;17:95-107.
6. Fitzwater J, Purdue GF, Hunt JL, et al. The risk factors and time course of sepsis and organ dysfunction after burn trauma. J Trauma. 2003;54:959-66.
7. Cerda E, Abella A, La Cal M, et al. Enteral vancomycin controls methicillin-resistant Staphylococcus aureus endemicity in an intensive care burn unit. Annals of Surgery. 2007;245:397-407.
8. Adam J, Dinger, John Brebbia, et al. Management of local burn wounds in the ED. Am J Emerg Med. 2007;25:666-71.
9. Estahbanati K, Kashani P, Ghanaatpisheh F. Frequency of Pseudomonas aeruginosa serotypes in burn wound infections and their resistance to antibiotics. Burns. 2002;28:340-8.
10. Sharma BR. Infection in patients with severe burns: Causes and prevention thereof. Infect Dis Clin North Am. 2007;21:745-59.
11. Herndon DN, Lal S. Is bacterial translocation a clinically relevant phenomenon in burns? Crit Care Med. 2000;28:1682-3.
12. Gamelli RL, He LK, Liu LH. Macrophage mediated suppression of granulocyte and macrophage growth after burn wound infection
reversal by means of anti-PGE2. J Burn Care Rehabil. 2000;21:64-9.
13. Hunt JP, Hunter CT, Brownstein MR, et al. The effector component of the cytotoxic T-lymphocyte response has a biphasic pattern after burn injury. J Surg Res. 1998;80:243-51.
14. Shoup M, Weisenberger JM, Wang JL, et al. Mechanisms of neutropenia involving myeloid maturation arrest in burn sepsis. Ann Surg. 1998;228:112-22.
15. Rong Y, Xin R, Hua R, et al. Pharmacokinectics of vancomycin and amikacin in the subeschar tissue fluid in patients with severe burn. Burns. 2009;35:75-9.
16. Peñuelas O, Cerdá E, Espino J, et al. Limb intracompartmental sepsis in burn patients associated with occult infection. Burns. 2010;36:558-64.
17. Silvestri L, van Saene HK, Milanese M, et al. Selective decontamination of the digestive tract reduces bacterial bloodstream infection and mortality in critically ill patients. Systematic review of randomized, controlled trials. J Hosp Infect. 2007;65:187-203.
18. De Smet AM, Kluytmans JA, Cooper BS, et al. Decontamination of the digestive tract and oropharynx in ICU patients. N Engl J Med. 2009;360:20-31.
19. Evidence-Based Guidelines Group; American Burn Association. Practice guidelines for burn care. J Burn Care Rehabil. 2001;(Suppl.):1-67s.
20. Rice PL. Emergency care of moderate and severe thermal burns in adults, in: Marx JA, Grayzel J, eds. 2008. www.uptodate.com/patients/content/topic.do?topicKey=~Ay/xsdTHiuaQHr.
21. White CE, Renz EM. Advances in surgical care: Management of severe burn injury. Crit Care Med. 2008;36:318-24.
22. D’Avignon LC, Saffle JR, Chung KK, et al. Prevention and management of infections associated with burns in the combat
casualty. J Trauma. 2008;64:277-86.
23. Church D, Elsayed S, Reid O, et al. Burn wound infections. Clin Microbiol Rev. 2006;19:403-34.
24. Silver GM, Klein MB, Herndon DN, et al. Standard operating procedures for the clinical management of patients enrolled in a prospective study of inflammation and the host response to thermal injury. J Burn Care Res. 2007;28:222-30.
25. Ressner RA, Murray CK, Griffith ME, et al. Outcomes of bacteremia in burn patients involved in combat operations overseas. J Am Coll Surg. 2008;206:439-44.
26. Avni T, Levcovich A, Ad-El D, et al. Prophylactic antibiotics for burns patients: Systematic review and meta-analysis. BMJ. 2010;340:c241.
27. Silvestri L, van Saene HK, Weir I, et al. Survival benefit of the full selective digestive decontamination regimen. J Crit Care. 2009;24:474.
28. Silvestri L, van Saene HK, Casarin A, Berlot G, Gullo A. Impact of selective decontamination of the digestive tract on carriage and infection due to Gram-negative and Gram-positive bacteria: A systematic review of randomized controlled trials. Anaesth Intens Care. 2008;36:324-38.
29. Leon J, Jeschke M, Herndom D. Topical management of facial burns. Burns. 2008;34:903-11.
30. Lowbury E, Lilly H, Cason J, et al. Alternative forms of local treatment for burns. Lancet. 1971;298:1105-11.
31. Atiyeh BS, Costagliola M, Hayek S, et al. Effect of silver on burn wound infections control and healing: Review of literature. J Burns. 2007;33:139-48.
32. Roba Khundkar, Claudia Malic, Tim Burge. Use of Acticoat dressing in burns. What is the evidence? J Burns. 2010;36:751-8.
33. Kaushik R, Kumar S, Sharma R, et al. Bacteriology of burn wounds- the first three years in a new burn unit at the Medical College Chandigar. J Burns. 2001;27:595-7.
34. Ulkur E, Oncul O, Karagoz H, et al. Comparison of silver-coated dressing (Acticoat), chlorhexidine acetate 0,5% (Bacti-gram) and fusidic acid (Fucidin) for topical antibacterial effect in methicillin- resistant Staphylococci-contaminated, full-skin thickness rat burn wounds. Burns. 2005;31:874 -7.
35. Smith R. Characterization of Staphylococcus aureus in a pediatric burn unit. Appl Microbiol. 1973;25:15-20.
36. Uygur F, Oncul O, Evinc R, et al. Effects of three different topical antibacterial dressings on Acinetobacter baumannii contaminated full-thickness burns in rats. Burns. 2009;35:270-3.
37. Fong J, Wood F, Fowler B, et al. A silver coated dressing reduces the incidence of early burn wound celulitis and associated cost of inpatient treatment: Comparative patient audits. Burns. 2005;31:562-7.
38. Wright JB, Lam K, Hanson D, et al. Efficacy of topical silver against fungal burn wound pathogens. Am J Infect Control. 1999;27:344-50.
39. Sheng-de G. Experimental study on topical antimicrobial agents in burns. Burns. 1987;13:277-80.
40. Dunn K, Jones VE. The role of Acticoat with nanocristalline silver in the management of burns. Burns 2004; 30:S1-S9.
41. Wright JB, Lam K, Hanson D, Burrel RE. Efficacy of topical silver against fungal burn wound pathogens. Am J Infect Control. 1999;27:344-50.
42. Bull JP, Jackson DM, Lowbury EJL et al. Local antibiotics for burns. Lancet. 1954;263:298.
43. Tredget E. Epidemiology of Infections with Pseudomonas aeruginosa in burn patients: The role of hydrotherapy. Clin Infect Dis. 1992;15:941-9.
44. Mangus D, Morgan L, Gilchrist D. The use of topical solutions in antibacterial burn wound therapy. Burns. 1977;3: 257-60.
45. Ip M, Lui SL, Poon V, et al. Antimicrobial activities of silver dressings: An in vitro comparison. J Med Microbiol. 2006;56:59-63.
46. Levenson S. Chemical debridement of burns. Ann Surg. 1974;180:670-703.
47. Lee F, Wong P, Hill F, et al. Evidence behind the WHO guidelines: hospital care for children. What is the role of prophylactic antibiotics in the management of burns? J Trop Pediatr. 2009;55:73-7.
48. Warriner R, Burrell R. Infection and the chronic wound: A focus on silver. Adv Skin Wound Care. 2005;18:2-12.
49. Wright JB, Lam K, Buret AG, Olson ME, et al. Early healing events in a porcine model of contaminated wounds: Effects of nanocrystalline silver on matrix metalloproteinases, cell apoptosis, and healing. Wound Repair and Regeneration. 2002;10:141-51.
50. Huang Y, Li X, Liao Z, et al. A randomized comparative trial between Anticoat and SD-Ag in the treatment of residual burn wounds, including safety analysis. Burns. 2007;33:161-6.
51. Demling RH, DeSanti MDL. The rate of re-epithelialization across meshed skin grafts is increased with exposure to silver. Burns. 2002;28:264-6.
52. Xue Q, Olena K, Roy MK. A retrospective review of burn dressings on a porcine burn model. Burns. 2009;36:680-7.
53. Poon VK, Burd A. In vitro cytotoxity of silver: Implication for clinical wound care. Burns. 2004;30:140-7.
2. Sanghavi P, Bhalla K, Das V. Fire-related deaths in India in 2001: a retrospective analysis of data. Lancet. 2009;373:1282-8.
3. Chim H, Tan BH, Song C. Five-year review of infections in a burn intensive care unit: High incidence of Acinetobacter baumannii in a tropical climate. Burns. 2007;33:1008-14.
4. Wibbenmeyer L, Danks R, Faucher L, et al. Prospective analysis of nosocomial infection rates, antibiotic use, and patterns of resistance in a burn population. J Burn Care Res. 2006;27:152-60.
5. Brigham PA, McLoughlin E. Burn incidence and medical care use in the United States: Estimate, trends, and data sources. J Burn Care Rehabil. 1996;17:95-107.
6. Fitzwater J, Purdue GF, Hunt JL, et al. The risk factors and time course of sepsis and organ dysfunction after burn trauma. J Trauma. 2003;54:959-66.
7. Cerda E, Abella A, La Cal M, et al. Enteral vancomycin controls methicillin-resistant Staphylococcus aureus endemicity in an intensive care burn unit. Annals of Surgery. 2007;245:397-407.
8. Adam J, Dinger, John Brebbia, et al. Management of local burn wounds in the ED. Am J Emerg Med. 2007;25:666-71.
9. Estahbanati K, Kashani P, Ghanaatpisheh F. Frequency of Pseudomonas aeruginosa serotypes in burn wound infections and their resistance to antibiotics. Burns. 2002;28:340-8.
10. Sharma BR. Infection in patients with severe burns: Causes and prevention thereof. Infect Dis Clin North Am. 2007;21:745-59.
11. Herndon DN, Lal S. Is bacterial translocation a clinically relevant phenomenon in burns? Crit Care Med. 2000;28:1682-3.
12. Gamelli RL, He LK, Liu LH. Macrophage mediated suppression of granulocyte and macrophage growth after burn wound infection
reversal by means of anti-PGE2. J Burn Care Rehabil. 2000;21:64-9.
13. Hunt JP, Hunter CT, Brownstein MR, et al. The effector component of the cytotoxic T-lymphocyte response has a biphasic pattern after burn injury. J Surg Res. 1998;80:243-51.
14. Shoup M, Weisenberger JM, Wang JL, et al. Mechanisms of neutropenia involving myeloid maturation arrest in burn sepsis. Ann Surg. 1998;228:112-22.
15. Rong Y, Xin R, Hua R, et al. Pharmacokinectics of vancomycin and amikacin in the subeschar tissue fluid in patients with severe burn. Burns. 2009;35:75-9.
16. Peñuelas O, Cerdá E, Espino J, et al. Limb intracompartmental sepsis in burn patients associated with occult infection. Burns. 2010;36:558-64.
17. Silvestri L, van Saene HK, Milanese M, et al. Selective decontamination of the digestive tract reduces bacterial bloodstream infection and mortality in critically ill patients. Systematic review of randomized, controlled trials. J Hosp Infect. 2007;65:187-203.
18. De Smet AM, Kluytmans JA, Cooper BS, et al. Decontamination of the digestive tract and oropharynx in ICU patients. N Engl J Med. 2009;360:20-31.
19. Evidence-Based Guidelines Group; American Burn Association. Practice guidelines for burn care. J Burn Care Rehabil. 2001;(Suppl.):1-67s.
20. Rice PL. Emergency care of moderate and severe thermal burns in adults, in: Marx JA, Grayzel J, eds. 2008. www.uptodate.com/patients/content/topic.do?topicKey=~Ay/xsdTHiuaQHr.
21. White CE, Renz EM. Advances in surgical care: Management of severe burn injury. Crit Care Med. 2008;36:318-24.
22. D’Avignon LC, Saffle JR, Chung KK, et al. Prevention and management of infections associated with burns in the combat
casualty. J Trauma. 2008;64:277-86.
23. Church D, Elsayed S, Reid O, et al. Burn wound infections. Clin Microbiol Rev. 2006;19:403-34.
24. Silver GM, Klein MB, Herndon DN, et al. Standard operating procedures for the clinical management of patients enrolled in a prospective study of inflammation and the host response to thermal injury. J Burn Care Res. 2007;28:222-30.
25. Ressner RA, Murray CK, Griffith ME, et al. Outcomes of bacteremia in burn patients involved in combat operations overseas. J Am Coll Surg. 2008;206:439-44.
26. Avni T, Levcovich A, Ad-El D, et al. Prophylactic antibiotics for burns patients: Systematic review and meta-analysis. BMJ. 2010;340:c241.
27. Silvestri L, van Saene HK, Weir I, et al. Survival benefit of the full selective digestive decontamination regimen. J Crit Care. 2009;24:474.
28. Silvestri L, van Saene HK, Casarin A, Berlot G, Gullo A. Impact of selective decontamination of the digestive tract on carriage and infection due to Gram-negative and Gram-positive bacteria: A systematic review of randomized controlled trials. Anaesth Intens Care. 2008;36:324-38.
29. Leon J, Jeschke M, Herndom D. Topical management of facial burns. Burns. 2008;34:903-11.
30. Lowbury E, Lilly H, Cason J, et al. Alternative forms of local treatment for burns. Lancet. 1971;298:1105-11.
31. Atiyeh BS, Costagliola M, Hayek S, et al. Effect of silver on burn wound infections control and healing: Review of literature. J Burns. 2007;33:139-48.
32. Roba Khundkar, Claudia Malic, Tim Burge. Use of Acticoat dressing in burns. What is the evidence? J Burns. 2010;36:751-8.
33. Kaushik R, Kumar S, Sharma R, et al. Bacteriology of burn wounds- the first three years in a new burn unit at the Medical College Chandigar. J Burns. 2001;27:595-7.
34. Ulkur E, Oncul O, Karagoz H, et al. Comparison of silver-coated dressing (Acticoat), chlorhexidine acetate 0,5% (Bacti-gram) and fusidic acid (Fucidin) for topical antibacterial effect in methicillin- resistant Staphylococci-contaminated, full-skin thickness rat burn wounds. Burns. 2005;31:874 -7.
35. Smith R. Characterization of Staphylococcus aureus in a pediatric burn unit. Appl Microbiol. 1973;25:15-20.
36. Uygur F, Oncul O, Evinc R, et al. Effects of three different topical antibacterial dressings on Acinetobacter baumannii contaminated full-thickness burns in rats. Burns. 2009;35:270-3.
37. Fong J, Wood F, Fowler B, et al. A silver coated dressing reduces the incidence of early burn wound celulitis and associated cost of inpatient treatment: Comparative patient audits. Burns. 2005;31:562-7.
38. Wright JB, Lam K, Hanson D, et al. Efficacy of topical silver against fungal burn wound pathogens. Am J Infect Control. 1999;27:344-50.
39. Sheng-de G. Experimental study on topical antimicrobial agents in burns. Burns. 1987;13:277-80.
40. Dunn K, Jones VE. The role of Acticoat with nanocristalline silver in the management of burns. Burns 2004; 30:S1-S9.
41. Wright JB, Lam K, Hanson D, Burrel RE. Efficacy of topical silver against fungal burn wound pathogens. Am J Infect Control. 1999;27:344-50.
42. Bull JP, Jackson DM, Lowbury EJL et al. Local antibiotics for burns. Lancet. 1954;263:298.
43. Tredget E. Epidemiology of Infections with Pseudomonas aeruginosa in burn patients: The role of hydrotherapy. Clin Infect Dis. 1992;15:941-9.
44. Mangus D, Morgan L, Gilchrist D. The use of topical solutions in antibacterial burn wound therapy. Burns. 1977;3: 257-60.
45. Ip M, Lui SL, Poon V, et al. Antimicrobial activities of silver dressings: An in vitro comparison. J Med Microbiol. 2006;56:59-63.
46. Levenson S. Chemical debridement of burns. Ann Surg. 1974;180:670-703.
47. Lee F, Wong P, Hill F, et al. Evidence behind the WHO guidelines: hospital care for children. What is the role of prophylactic antibiotics in the management of burns? J Trop Pediatr. 2009;55:73-7.
48. Warriner R, Burrell R. Infection and the chronic wound: A focus on silver. Adv Skin Wound Care. 2005;18:2-12.
49. Wright JB, Lam K, Buret AG, Olson ME, et al. Early healing events in a porcine model of contaminated wounds: Effects of nanocrystalline silver on matrix metalloproteinases, cell apoptosis, and healing. Wound Repair and Regeneration. 2002;10:141-51.
50. Huang Y, Li X, Liao Z, et al. A randomized comparative trial between Anticoat and SD-Ag in the treatment of residual burn wounds, including safety analysis. Burns. 2007;33:161-6.
51. Demling RH, DeSanti MDL. The rate of re-epithelialization across meshed skin grafts is increased with exposure to silver. Burns. 2002;28:264-6.
52. Xue Q, Olena K, Roy MK. A retrospective review of burn dressings on a porcine burn model. Burns. 2009;36:680-7.
53. Poon VK, Burd A. In vitro cytotoxity of silver: Implication for clinical wound care. Burns. 2004;30:140-7.
Cómo citar
Nieto, L. E., Acosta, L. M. A., Bedoya, M. A., & Tapias, V. (2011). Profilaxis antibiótica en quemaduras. Universitas Medica, 52(4), 399–408. https://doi.org/10.11144/Javeriana.umed52-4.paqu
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