成人轻中度烧烫伤患者全身抗生素使用与预后相关性分析研究OA

Objective To analyze the impact of systemic antibiotic use on factors such as the incidence of infection,wound healing rate,and length of hospital stay in adult patients with mild-to-moderate burns.Methods A total of 53 adult patients with mild to moderate burns(total burn area≤30%total body surface area,with third-degree burns≤2%)admitted to the 910th Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army from January 2019 to April 2020 were retrospectively enrolled.According to the administration of systemic antibiotics,the patients were initially divided into a systemic antibiotic group(n=26)and a non-systemic antibiotic group(n=27).After 1∶1 propensity score matching(PSM),8 cases were finally included in each group.The baseline data,laboratory test indicators,other intervention measures,as well as the outcomes and prognosis before and after PSM were compared between the two groups.Results The area of third-degree burn in the systemic antibiotic group[0.05(0,1.00)%TBSA]was higher than that in the non-systemic antibiotic group[0(0,0)%TBSA],with a statistically significant difference(z=-2.437,P<0.05).The proportions of fever,white blood cell(WBC)count,neutrophil count,surgical intervention,and topical antibiotic use in the systemic antibiotic group[50.00%(13/26),(12.18±4.18)×109/L,(9.03±3.92)×109/L,34.62%(9/26),and 53.85%(14/26),respectively]were higher than those in the non-systemic antibiotic group[14.81%(4/27),(8.55±2.35)×109/L,(5.79±2.01)×109/L,0%TBSA(0/27),and 25.93%TBSA(7/27),respectively],with statistically significant differences(χ2=7.526;t=-3.880,-3.764;χ2=8.936,4.316,P<0.05).Before propensity score matching,the total hospitalization cost in the systemic antibiotic group[15,147(11,164;20,795)yuan]was significantly higher than that in the non-systemic antibiotic group[7,773(4,463;10,243)yuan];(z=-4.341,P<0.001).After propensity score matching,there were no statistically significant differences between the two groups in terms of infection rate,wound healing rate at discharge,length of hospital stay,and wound healing time(P>0.05).Conclusions For adult patients with mild to moderate burns and scalds with a total burn area≤30%TBSA and a third-degree burn area≤2%TBSA,the use of systemic antibiotics does not benefit in reducing the incidence of infection,local wound outcome,and shortening hospital stay,even increases the total hospitalization cost.