Characterization, Treatment Pattern And Use Of Antibiotics In Burn Patients Of Quetta Pakistan

Abstract

Background: Burn injuries represent a significant cause of morbidity and mortality, particularly in low-resource settings where treatment is often delayed, injury patterns are severe and empirical antimicrobial usage may be detrimental to outcomes. This study evaluated the demographic, clinical, drug-related, and outcome characteristics of burn patients who were admitted to tertiary care hospitals in Quetta.

Methods: A retrospective hospital-based descriptive study, using patient record review was conducted at the burn units of Sandeman Provincial Hospital Quetta and Bolan Medical Complex Hospital Quetta. This was a retrospective study using a structured proforma to review the medical records of patients admitted to the burns unit in 2022, 2023, and 2024. Demographics, burn characteristics, antibiotic prescribing, culture sensitivity, treatment outcomes and mortality associated factors were extracted and SPSS was used for analysis. Descriptive statistics were calculated as frequencies, with chi-square test applied for associations between clinical variables and mortality (p<0.05).

Results: We included 557 burn patient records. The majority of patients were aged 3–6 years (22.8%), male (57.6%) and were from Quetta (59.2%). Flame burns (47.4%) and scald burns (42.2%) were the two most common causes. Prevalence of second-degree burns (63.4%) and burns involving 11–20% total body surface area (41.8%) were most evident. Ceftriaxone represented the most frequently prescribed antibiotic (61.8%) and the intravenous route (98.9% cases). Complete isolated organism culture sensitivity testing (for all isolated organisms) performed in only in 4.7% of patients; 28.5% patients needed antibiotic change after culture results. Sixty-five per cent of patients were discharged alive (65.5%), while 14.5% died. Mortality was significantly associated with cause of burn (p=0.040), percentage total burn surface area (TBSA) (p<0.001), burn degree (p<0.001) and hospital stay (p=0.007).

Conclusion: Mortality was most significantly predicted by burn severity. Better burn prevention, early severity directed management, and more robust microbiological support is required to enhance burn care metrics in Quetta.