The concept of burn wound sepsis and the demonstration of the avascular nature of the burn wound paved the way for the development of effective antibacterial therapy of the burn wound. Many agents have been tried, but the most effective are those with a broad spectrum of antibacterial activity, lack of developing resistance, low toxicity, and active penetration of the wound. The resultant lowering of mortality and improvement in patient care have dramatically altered the prognosis of burn injury. The primary drugs in use today, their advantages and limitations, and the pathophysiology of the burn wound and burn wound sepsis are presented.