Rational Selection and Use of Antimicrobials in Patients with Burn Injuries

Clin Plast Surg. 2017 Jul;44(3):521-534. doi: 10.1016/j.cps.2017.02.012. Epub 2017 Apr 21.

Abstract

Caring for patients with burn injuries is challenging secondary to the acute disease process, chronic comorbidities, and underrepresentation in evidence-based literature. Much current practice relies on extrapolation of guidance from different patient populations and wide variations in universal practices. Identifying infections or sepsis in this hypermetabolic population is imperfect and often leads to overprescribing of antimicrobials, suboptimal dosing, and multidrug resistance. An understanding of pharmacokinetics and pharmacodynamics may aid optimization of dosing regimens to better attain treatment targets. This article provides an overview of the current status of burn infection and attempts recommendations for consideration to improve universally accepted care.

Keywords: Antimicrobials; Biomarkers; Burn; Dosing; Infections; Pharmacodynamics; Pharmacokinetics; Sepsis.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents / pharmacokinetics
  • Anti-Bacterial Agents / therapeutic use*
  • Bacterial Infections / prevention & control*
  • Biomarkers
  • Burns / complications
  • Burns / drug therapy*
  • Humans

Substances

  • Anti-Bacterial Agents
  • Biomarkers