Systemic antibiotic prophylaxis does not affect infectious complications in pediatric burn injury: A meta-analysis

PLoS One. 2019 Sep 25;14(9):e0223063. doi: 10.1371/journal.pone.0223063. eCollection 2019.

Abstract

In pediatric burns the use of systemic antibiotic prophylaxis is a standard procedure in some burn centers, though its beneficial effect on the infectious complications is debated. The present meta-analysis aimed at determining whether systemic antibiotic prophylaxis prevents infectious complications in pediatric patients with burn injuries. We searched the PubMed, EMBASE, and Cochrane Library databases from inception to August 2019. We included 6 studies, in which event rates of infectious complications were reported in children with burn injuries receiving or not receiving systemic antibiotic prophylaxis. We found that the overall odds ratio (OR) of developing an infection (including local and systemic) was not different between the groups (OR = 1.35; 95% CI, 0.44, 4.18). The chances for systemic infectious complications alone were also not different between antibiotic-treated and non-treated patients (OR = 0.74; 95% CI, 0.38, 1.45). Based on the age, affected total body surface area, and country income level, we did not find any subgroup that benefited from the prophylaxis. Our findings provide quantitative evidence for the inefficacy of systemic antibiotic prophylaxis in preventing infections in pediatric burns. To validate our conclusion, multinational, randomized trials in a diverse population of children with burn injuries are warranted.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Bacterial Agents / therapeutic use*
  • Antibiotic Prophylaxis / methods*
  • Antibiotic Prophylaxis / statistics & numerical data
  • Bacterial Infections / epidemiology*
  • Bacterial Infections / etiology
  • Bacterial Infections / prevention & control
  • Burns / complications*
  • Child
  • Humans
  • Incidence
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents

Grant support

This work was supported by the National Research, Development and Innovation Office (FK 124483 to AG), the Medical School, University of Pecs (KA-2019-27 to AG), the Higher Education Institutional Excellence Program of the Ministry of Human Capacities in Hungary (20765-3/2018/FEKUTSTRAT to PH and AG), GINOP STAY ALIVE (2.3.2-15-2016-00048 to PH), and EFOP LIVE LONGER (3.6.2-16-2017-00006 to PH). AG acknowledges the Janos Bolyai Scholarship of the Hungarian Academy of Sciences. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.