Antimicrobial Victimization

The reason of sepsis with burns is quite complicated as a very high temperature damages the skin and underlying tissues and disrupts the different protecting layers of skin thus the walls of blood vessels, which are like a tight fabric in healthy human, get transformed into a loose mesh and all the fluid containing proteins oozes out to accumulate within broken skin and tissues. This nutrient rich fluid is an invitation for all sorts of microorganisms which flourish on it, usually, these microbes cannot enter the blood as the skin acts like a barrier, but now as it is damaged; bacteria can enter without difficulty and produce a life-threatening situation called sepsis. Infection is the most important reason of morbidity and mortality in burns. Staphylococcus aureus and Pseudomonas aeruginosa are the most frequently colonizing bacteria whereas group-a beta-hemolytic streptococci are the most virulent bacteria and anaerobic bacteria as well as fungi are also common, viral infection is less prevalent (3, 4).
The aim of topical antimicrobial treatment is to control microbial colonization and their consequent proliferation. Today, silver sulfadiazine is the most widely used topical antimicrobial for burn treatment. Silver sulfadiazine has numerous clinical advantages, including a broad antimicrobial spectrum and low toxicity. Silver sulfadiazine has in vitro activity against many burn wound pathogens including Pseudomonas aeruginosa, Staphylococcus aureus, Escherichia coli, Klebsiella, Proterus, Enterobacteriaceae and Candida albicans. The frequency of resistance development with silver sulfadiazine is considerably lower than with other antimicrobials. So in the majority of burn patients the drug of preference for prophylaxis is silver sulfadiazine