Gentamicin in the management of thermal injuries.

Abstract

greatest threat to survival for the patient who has suffered an extensive burn. The past 20 years have witnessed the control of gram-positive organisms by a group of specific antistaphylococcal drugs which are now effective against the resistant staphylococci which emerged after the early widespread use of penicillin. This effective suppression of the gram-positive flora in the hospital environment has, however, resulted in the emergence of a group of gram-negative bacteria which have until recently been resistant to most available antibiotics [1]. The clinical pictures associated with invasive infection secondary to predominantly gram-positive and gram-negative burn wound sepsis differ from one another. Patients suffering from grampositive invasive infection show early dissolution of granulation tissue, have an insidious course lasting from 2 to 6 days, are severely disoriented and hyperpyrexic, and display a moderate to severe degree of gastrointestinal ileus. Hypotension followed by oliguria is also characteristic of this syndrome. The laboratory findings show a marked elevation in the white blood count, in contrast to a leukopenia seen in those patients suffering from overwhelming gram-negative sepsis.