title: Comparison of silver sulfadiazine 1% with chlorhexidine digluconate 0.2% to silver sulfadiazine 1% alone in the prophylactic topical antibacterial treatment of burns.
abstract: Wound bacterial colonization in 118 patients treated with chlorhexidine digluconate 0.2% in silver sulfadiazine 1% applied daily to the burn wounds was compared to that of 135 comparable patients similarly treated with silver sulfadiazine 1%. With chlorhexidine digluconate 0.2% in silver sulfadiazine 1%, colonization by Staphylococcus aureus was less frequent (38%) than with silver sulfadiazine (54%, p = 0.016). No statistical difference was found for colonization by Enterococcus faecalis, Pseudomonas aeruginosa, or Enterobacter cloacae. Washing of the wounds of 65 patients with chlorhexidine gluconate 4% during daily dressing changes was associated with reduced wound colonization by S. aureus (35% versus 51%, p = 0.03) and P. aeruginosa (8% versus 16%, p = 0.08) when compared to the 188 washed with nonantibacterial soap. Chlorhexidine, whether added to the topical agent silver sulfadiazine (chlorhexidine digluconate 0.2%) or in the bath soap (chlorhexidine gluconate 4%), decreased colonization by S. aureus.
authors.affiliation: Division of Plastic Surgery, University of British Columbia, Vancouver, Canada.
authors.forename: C F
authors.initials: CF
authors.lastname: Snelling
authors.forename: R J
authors.initials: RJ
authors.lastname: Inman
authors.forename: E
authors.initials: E
authors.lastname: Germann
authors.forename: J C
authors.initials: JC
authors.lastname: Boyle
authors.forename: B
authors.initials: B
authors.lastname: Foley
authors.forename: D A
authors.initials: DA
authors.lastname: Kester
authors.forename: D J
authors.initials: DJ
authors.lastname: Fitzpatrick
authors.forename: R J
authors.initials: RJ
authors.lastname: Warren
authors.forename: A D
authors.initials: AD
authors.lastname: Courtemanche
mesh_terms: D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D000336:Aerosols; D000704:Analysis of Variance; D001419:Bacteria / Q000187:drug effects / Q000254:growth & development*; D002056:Burns / Q000382:microbiology*; D002648:Child; D002710:Chlorhexidine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D015169:Colony Count, Microbial; D004359:Drug Therapy, Combination; D006801:Humans; D008875:Middle Aged; D009666:Nose / Q000382:microbiology; D010614:Pharynx / Q000382:microbiology; D012837:Silver Sulfadiazine / Q000627:therapeutic use*; D013211:Staphylococcus aureus / Q000187:drug effects / Q000254:growth & development / Q000302:isolation & purification
chemical_list: D000336:Aerosols; C010882:chlorhexidine gluconate; D002710:Chlorhexidine; D012837:Silver Sulfadiazine