Antibiotics for severe burns yes or no?

Should prophylactic antibiotics be given to burns patients? A systematic review of 17 trials concludes they may reduce all-cause mortality when given for 4-14 days after admission; there was a reduction in pneumonia with systemic prophylaxis and a reduction in wound infections with perioperative prophylaxis. However the overall methodological quality of the trials was poor and in three trials, resistance to the antibiotic used for prophylaxis significantly increased. The authors consequently do not recommend prophylaxis for patients with severe burns other than perioperatively.
Take home message: not needed as part of critical care resuscitation
Prophylactic antibiotics for burns patients: systematic review and meta-analysis
BMJ. 2010 Feb 15;340:c241