Simple, effective and affordable approach for the treatment of burns infections

• Published in: Burns 2010-12, Vol.36 (8), p.1242-1247
• Main Authors: Nagoba, Basavraj S, Gandhi, Rajan C, Hartalkar, Amol R, Wadher, Bharat J, Selkar, Sohan P
• Format: Article
• Language: English
• Subjects: Adult; Anti-Bacterial Agents - therapeutic use; Biological and medical sciences; Burns; Burns - complications; Burns - microbiology; Burns infection; Citric Acid - pharmacology; Citric Acid - therapeutic use; Citric acid treatment; Critical Care; Female; Gram-Negative Bacteria - drug effects; Gram-Negative Bacteria - isolation & purification; Gram-Positive Bacteria - drug effects; Gram-Positive Bacteria - isolation & purification; Humans; Male; Medical sciences; Microbial Sensitivity Tests; Middle Aged; Traumas. Diseases due to physical agents; Wound Healing - drug effects; Wound Infection - drug therapy; Wound Infection - microbiology
• ISSN: 0305-4179; 1879-1409
• DOI: 10.1016/j.burns.2010.05.011

Abstract Objective The aim of the present study was to develop a simple and effective treatment modality using citric acid as a sole antimicrobial agent to control infections in burns patients not responding to conventional treatment. Methods Forty-six cases with 5–60% superficial to deep burns in a study group and 20 cases with 10–70% superficial to deep burns in a control group were investigated for culture and susceptibility. The isolates in study group were further tested for susceptibility to citric acid. Three percent citric acid gel was applied to burns wounds in study group; however, the control group received conventional antibiotic therapy and local wound care. Results In the control group, Pseudomonas aeruginosa (44.44%) and Staphylococcus aureus (33.33%) were found to be the commonest bacterial isolates and, amikacin and ciprofloxacin (40.74%) were found to be most effective antibacterial agents. In study group, P. aeruginosa (30.48%) and S. aureus (23.17%) were found to be the commonest bacterial isolates. Ceftazidime (52.43%), ciprofloxacin (47.56%) and amikacin (46.34%) were found to be most effective antibacterial agents. Application of citric acid to burn wounds resulted in complete healing in 40 (86.95%) cases in 7–25 applications ( P value 0.145); however, in a control group conventional antibiotic therapy and local wound care resulted in complete healing in nine (45%) patients only. Conclusions Citric acid treatment was found effective in the control of burns infections as compared to conventional therapy. Complete healing in 86.95% cases as compared to 45% in a control group indicates that citric acid is nontoxic, economical and quite effective in the management of burns infections.