Antimicrobial Prophylaxis
1. Prophylactic IV antibiotics are not indicated for burn injury in the absence of infection. Penetrating wounds or open fractures should be treated with antibiotics according to current guidelines. See Wound Care section for discussion of topical antimicrobials.
2. Administer tetanus prophylaxis as for any trauma patient.
3. If wound infection is diagnosed clinically, direct empiric therapy against gram positive and gram negative bacteria based on known geographic susceptibilities. If this data is unavailable, a good starting point is broad coverage with vancomycin for gram positive organisms and a carbapenem or 4th generation cephalosporin for gram negative organisms.