Prescription pattern of empirical antibiotic therapy in the burn unit of a tertiary care setting in the Kingdom of Saudi Arabia

Background: It is crucial to follow rational prescribing practices while prescribing antibiotics for burn patients, thus leading to better patient outcomes. The objective of this study was to assess the initiation of empirical antibiotics in the burn unit.

Methods: A prospective cross-sectional study was conducted in a large tertiary care setting of the Kingdom of Saudi Arabia between August 2016 and December 2018.

Results: A total of 102 hospitalized burn patients were included in this study, of whom 84 (82.4%) were males. Burns were classified as first degree, second degree, third degree, or fourth degree depending on their severity and extent of penetration into the skin. The majority (81.3%) of the patients suffered from flame burn, followed by scald (9.85), chemical (6.9%), and electrical (2%) types of burns. Broad-spectrum antibiotic such as piperacillin/tazobactam (40.57%) was the most common empirically prescribed antibiotic. In 35 patients (34.3%), there was a change in antibiotic after culture findings.

Conclusion: This study demonstrated that 40% of antibiotic therapy decisions followed the recommended clinical guidelines. This study also found that Gram-negative microorganisms such as Pseudomonas aeruginosa and Methicillin-resistant Staphylococcus aureus were ubiquitous in our burn unit. The study results will facilitate to develop antibiogram for our study setting, thus reducing antibiotic resistance. Further studies are needed to explore the extent and consequences of irrational antibiotic prescriptions in critically ill burn patients.