Effect of an antibiotic treatment protocol on burns at the Surgical Department of Komfo Anokye Teaching Hospital

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Objective: The study was carried out to determine the impact of an established antibiotic treatment protocol on mortality and length of hospital stay for survivors of burns. The antibiotic treatment protocol consisted of burn patients receiving Co-amoxiclav plus Gentamicin and or Ceftazidime starting from the first day of admission, and acetic acid dressing for infected wounds. Also the study determined the age distribution of burn victims and the common causes of bums reported to the Burns Unit. Method: The study was retrospective, covering a two-year period, April 2001 to April 2002 before the introduction of the protocol and May 2002 to May 2003 after the introduction. The protocol was implemented in May 2002. The study was also non-randomised and hence all patients who fell within the said period were used. Setting: Burns Unit of Komfo Anokye Teaching Hospital, Ghana. Key Findings: The ages of the patients ranged from one month to seventy years. Most burns occurred in children and those below eleven years constituting more than 60% for both periods. Majority of the burns occurred at home; mainly thermal and most of the causes were hot water, hot soup, flames and gas explosion for both periods. The most common organism isolated from culture and sensitivity tests was Ps aeruginosa. The introduction of the protocol led to a reduction in mortality rate of 18.1% before to 12.0% after the protocol. The mean length of hospital stay for survivors before the introduction of the protocol was 8.6 days whilst that after the protocol was 13 days. Conclusions: Most burns were domestic, mainly thermal which were due to hot water, hot soup, flames, gas explosion etc, because of poor home safety and poor cooking and heating devices. Majority of the burns population were children below eleven years mainly because of inadequate supervision as a result of large family sizes and also lack of domestic safety measures. The introduction of the protocol has led to some improvement in patient outcome.
A Thesis submitted to the Department of Clinical and Social Pharmacy, Kwame Nkrumah University of Science and Technology in partial fulfillment of the requirements for the degree of Master of Science, 2005