An Evaluation of Antibiotic Use in the Hospitalized Burn Patients

입원화상환자의 특성과 항생제 사용 현황

Infection is one of the main causes of death in severe burn cases. Treatment of burn patient includes fluid therapy, wound care, complication care and antibiotic therapy for infection. The objective of this study was to evaluate the characteristics of burn patients, the type of isolated microorganisms and their susceptibility, and the systemic antibiotics used. This is a retrospective study of 126 burn patients treated in the Hanil General Hospital from January to December 2001. Total 126 patients were assessed with 103 males and 23 females (4.5:1). The average age was $34.8\pm17.6$ years and extent of burn $(TBSA\;\%)\;was\;24.5\pm18.5\%$. The burn was caused by electric accident $(47.6\%),\;flame\;(29.4\%),\;scalding\;(21.4\%),\;and\;chemical\;accident\;(1.6\%)$. The overall mortality rate was $7.14\%$ (9/126) and all expired patients were males. The average age (n=9) was $48.8\pm15.6$ yrs and the extent of burn was $65.0\pm19.0\%$. The causes of death were due to flame burns $(13.5\%)$ and electric burns $(6.7\%)$. The culture sites of the isolated microorganisms were wound $(85.3\%),\;sputum\;(9.3\%),\;urine\;(2.7\%),\;blood\;(1.3\%)\;and\;catheter\;tip\;(1.3\%)$. Pseudomonas aeruginosa was the most commonly isolated organism $(35\%)$, followed by Staphylococcus aureus $(30.1\%)$, Acinetobacter baumannii $(21.4\%)$, and Enterococcus spp. $(3.9\%)$. The number of systemic antibiotics administered was 4.5. The classes of the antibiotics were cephalosporines $(38.5\%)$, aminoglycosides $(31\%)$, quinolones $(13.3\%)$, penicillins $(12.4\%)$, carbapenems $(2.4\%)$, glycopeptides $(1.9\%)$ and others $(0.6\%)$. In conclusion, most of burn patients had wound infection and Pseudomonas aeruginosa was the most commonly isolated organism. Cephalosporins were administered the most frequently among antibiotics.