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Burn injuries are unique in comparison to other types of trauma because of their severity and major systemic impact produced by extensive lesions with disfunctions that can persist even several years after the injury. Multiple complications can occur during burn injury evolution, from which infections are the most severe and the most frequently encountered, requiring adequate diagnosis and treatment. In most burn centers, increased mortality rates associate with severe burn injuries aggravated by the development of sepsis. There are multiple sources of infections in burned patients: lungs, wounds, catheters, gastrointestinal and urinary tract. Pathogens are often multi-resistant bacteria but also fungi and viruses appear as opportunistic infections. The main goal is represented by prevention of organ dysfunction development through specific supportive measures that avoid its onset. Early excision of the burn eschar and wound grafting is essential for patient outcome, decreasing duration of hospitalization, infectious risk and mortality. As a principle, antibiotic treatment in burn infectious complications is started empirically, with broad spectrum agents if the results of microbiological cultures are not available and immediately after the antibiogram is available, targeted antibiotic is introduced. De-escalation strategy is promoted in order to prevent antimicrobial resistance: narrow spectrum drugs with proven efficacy on determined germs are administered, avoiding if possible, reserve antibiotics. [ABSTRACT FROM AUTHOR]

Severe burn injuries represent a major challenge to the entire healthcare system in developing countries and even for states with a high standard of care. A clear understanding of the physiopathology of burn injuries is essential for providing an adequate prompt treatment to ensure an optimal patient outcome. Early recognition and treatment of burns complications, especially severe infections represent an important prevention strategy, improving survival after these severe injuries. Specific treatment must be conducted according to the characteristics of the patients in order to reduce morbidity and mortality and avoid the development of antimicrobial resistance. A diagnostic and therapeutic algorithm is presented, centered on infectious source prevention and control with early surgical excision and skin grafting together with culture-guided antimicrobial therapy. It is a known fact that, indifferent of the involved germ, the best intervention for both prophylaxis and treatment of infections in the burn patient is the early excision of the devitalized tissue and subsequent closure of burn wounds with skin grafts, measures that diminish local and systemic mediator releasing effects in burnt tissue, attenuating the progressive inflammatory chain. [ABSTRACT FROM AUTHOR]