The selective use of systemic antibiotics in the treatment of burns.

For the past ten years, we have followed a conservative program in using systemic antibiotics for the treatment of significant burns. Prophylactic antibiotics are not used except for scalds. Antibiotics are given selectively at the time of operation and, otherwise, are reserved for the treatment of specific infections. It has been unusual for a patient with a burn severity index, compatible with survival, to die of uncontrolled sepsis. Resistant bacteria and fungi have not been a problem. We attribute this to the selective use of antibiotics.