Dr Patrick Lu1, Dr Dane Holden1, Dr Alex Padiglione1, A/Prof Heather Cleland1
1Victorian Adult Burns Service, , Australia
Perioperative antibiotic prophylaxis is perceived to reduce intra-operative bacteraemia and prevent surgical site infections, however, its evidence for its use in burns surgery is limited. Excessive usage of perioperative antibiotics has become a growing concern. The authors aimed to audit the prescribing practices of perioperative antibiotic prophylaxis at the Victorian Adult Burns Service and determine whether the duration of antibiotic prophylaxis influenced the risk of post-operative wound infection, bacteraemia and antibiotic resistance.
This retrospective chart review included all acute adult burns patients who had an operation between November 2018 and November 2019. Basic demographic data, burn specific data and perioperative antibiotic use data were collected. The outcome measures were wound infection, bacteraemia, other infections and presence of resistant organisms.
Results demonstrated that almost all patients (98.6%) received perioperative antibiotic prophylaxis. On comparison, there was no significant difference between the rate of post-operative wound infection, bacteraemia or antibiotic resistance between patients receiving a short or long course of antibiotics.
The results of our study demonstrate variable use of perioperative antibiotic prophylaxis within one burns unit. There were many cases of unsubstantiated use of long courses of antibiotics without apparent benefit on clinical outcomes of wound infection or bacteraemia. With the growing concern over antibiotic overuse and development of resistance, there is an increasing need for development of clear guidelines for antibiotic use in burns surgery.
Patrick is a junior doctor from Melbourne with a strong interest in burns surgery, having completed a research degree with the Victorian Adult Burns Service in 2019. He is particularly interested in improving perioperative outcomes for burns patients.