Ask the expert


Skin burn antibiotics

13 weeks ago I burnt my arm against a heated towel rail and sustained a partial thickness burn on my arm. The nurse at my local doctors surgery has been treating this but it doesn't seem to be healing and feel like we are going round in circles. I have had two Staff infections in it, which were treated with antibiotics. Is this too long to be taking to heal and should they be suggesting a skin graft now? Part of it is healing in a keloid type scar but there are still areas where the skin has not grown over and it bleeds and is over granulated. Your advice would be appreciated as I am going twice a week to have the dressing changed. P.S. I am allergic to the silver ointment.

1 March 2021

Thank you for contacting Health at Hand.

How long it takes to recover from a burn or scald depends on how serious it is and how it's treated. If the wound becomes infected, NHS guidance on how it is usually managed is as follows:

Signs that a wound is infected

  • If the wound becomes increasingly uncomfortable, painful, or smelly
  • if cellulitis is observed, or
  • if the person develops a fever.

First response

  • The wound is cleaned using 0.9% sodium chloride or lukewarm tap water.
  • If an infection is suspected, a swab is taken from the burn wound.

Treatment for infected wounds

If antibiotic treatment is indicated, the NHS recommends the following:

  • A 7 day course flucloxacillin is usually prescribed as first line, however if patient is allergic to penicillin, a course erythromycin is given instead. For those who are known not to tolerate erythromycin, clarithromycin can be given as a substitute.
  • Usually a dose, that is high enough to ensure adequate wound penetration is prescribed
  • A 7 day course is prescribed initially, however if symptoms do not fully resolved after 7 days, continuing the antibiotic for up to a further 7 days is recommended
  • Additional pain relief is usually recommended to manage pain symptoms at the same time as antibiotic treatment, e.g. paracetamol or ibuprofen, plus codeine for more severe pain.
  • If there is poor, or no, clinical response to the prescribed antibiotics, it is advisable to go back to the doctor as they may require to assess the burn wound further and possibly change the antibiotic or decide on a further course of action as required.

Infected wounds and scarring

Most skin burns are likely to leave minimal scarring; you can reduce the risk of scarring after the wound has healed by:

  • Applying ointment e.g. Aqueous cream / emulsifying ointment, two to three times a day or as otherwise directed
  • Using sunscreen to enable healing whilst reducing possible sun exposure.

We hope that is of some assistance to you.

Answered by the Health at Hand team.

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