ANTIMICROBIAL PROPHYLAXIS

Prophylactic systemic antibiotics are not indicated for burn injury in the absence of infection. Penetrating wounds or open fractures should be treated with antibiotics according to respective guidelines. See the Wound Care section for discussion of topical antimicrobials.

- Administer tetanus prophylaxis as for any trauma patient.
- If wound infection is diagnosed clinically (e.g., burn-wound cellulitis, purulent drainage, marked changes in the color of the eschar, or ongoing conversion of partial thickness burns to full thickness burns), direct empiric therapy against Gram-positive and Gram-negative bacteria is indicated based on known geographic susceptibilities. If these data are unavailable, broad coverage with vancomycin for Gram positive organisms and a carbapenem (meropenem) or 4th generation cephalosporin (cefepime) for gram negative organisms is advised. If in the Role 1 environment and only have Ertapenem, that is acceptable.