Experimental and clinical studies on cefclidin in the treatment of burns: Penetration into the eschar and its effects on burn wound infection

An experimental study was undertaken to determine the effects of intravenously administered cefclidin (CFCL) on the prevention of burn wound sepsis occurring in contaminated full-thickness burns. The penetration of the antibiotics into the eschar was also studied. Also, CFCL was used in five patients with infected burn wounds to test its clinical effects. The results were as follows: 1. All control wounds showed signs of infection, whereas wounds treated CFCL had no signs of infection. 2. Histology showed numerous inflammatory cells in the eschar of control wounds. Wounds treated with CFCL showed minimal inflammation. 3. Quantitative cultures indicated more than 10⁵ cfu/g bacteria in 9 out of 10 control wounds, but only one wound had a positive culture in wounds treated CFCL. 4. High CFCL levels in burned tissue were observed. The levels were higher than those in control skin, and superficial layer showed higher levels than in deep layers. 5. Five burned patients received intravenous CFCL (1 or 2g), bid for 5–7 days. The clinical efficacy was good in 3, fair in 1 and unevaluable in 1. As for bacteriological response, 5. aureus (2 strains), Streptococcus sp. (1 strain), P. aeruginosa (1 strain) and P. acnes (1 strain) were eradicated, but S. epidermidis (1 strain) was unchanged. No adverse drug reaction was noted, but slight abnormal laboratory changes in GPT were observed in 2 patients. The effects of CFCL in controlling the burn wound sepsis were attributed to the high tissue penetration as well as its good antibacterial activity.