Relationship between prognosis and timing of antimicrobial use in the treatment of severe flame burns: a single-centre retrospective study

Infections are the most common cause of mortality in patients with burns and are, therefore, a major challenge in burn treatment. Appropriate infection control measures are required for a good prognosis with respect to wound infections. Infection prevention improves the outcomes of burn patients. We aimed to determine the efficacy of early antimicrobial therapy in patients with severe flame burns. We conducted a single-centre, observational, case-control study to assess the relationship between prognosis and timing of antimicrobial therapy in the treatment of severe burns in emergency department patients from April 2018 to March 2020. The primary outcome was the association between the initiation of antimicrobial use and prognosis in patients with severe burns. Twenty-three participants were included in the study: 14 in the Control group, and nine in the Case group (patients with severe flame burns). Analysis of the association between the number of days from admission to the emergency department to the start of antimicrobial therapy and length of hospital stay showed a significant correlation in the Case group (P = 0.0006) but not in the Control group (P = 0.9630). Furthermore, in the Case group, the number of days from admission to initiation of antimicrobial therapy was significantly shorter in the group with a good skin condition prognosis (median, 4; range, 2-5) than in the group with a poor skin condition prognosis (median, 9; range, 7-14) (P = 0.0256). This study showed that early use of antimicrobials in patients with severe burns leads to improved skin graft outcomes and shorter hospital stays for patients.