Wound management in an era of increasing bacterial antibiotic resistance: a role for topical silver treatment.
BACKGROUND
Antibiotic-resistant bacteria represent an increasing concern in wound infections. Wound colonization with these organisms normally results in aggressive management of the wound complicated by a greatly limited choice of therapeutic antibiotics. Silver and other noble metals are recognized as potential allies in combating these organisms in wounds.


METHODS
Three types of topical silver applications were tested to determine their bactericidal efficacies against clinical isolates of antibiotic-resistant organisms. The silver-based applications represent 3 methods of applying silver to wounds: as a liquid (silver nitrate), incorporated in a cream (silver sulfadiazine) and as a dressing coating (silver-coated dressings). The reduction in the viable bacterial population recovered from test articles after exposure to silver provided a comparative measure of the bactericidal efficacies of these silver applications.


RESULTS
All of the products demonstrated an ability to reduce the number of viable bacteria. However, the methods varied in their efficacy against antibiotic-resistant bacteria, with the silver-coated dressing being the most efficacious and silver nitrate the least efficacious.


CONCLUSIONS
Silver was demonstrated to be effective at killing the antibiotic-resistant strains tested. The silver-coated dressing was particularly rapid at killing the tested bacteria and was effective against a broader range of bacteria. Silver may be a useful prophylactic or therapeutic agent for the prevention of wound colonization by organisms that impede healing, including antibiotic-resistant bacteria.
Wright
J B
JB
Westaim Biomedical Corp, Fort Saskatchewan, Alberta, Canada.
Lam
K
K
Burrell
R E
RE
D000279:Administration, Cutaneous; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000382:microbiology / Q000517:prevention & control*; D001458:Bandages; D003428:Cross Infection / Q000382:microbiology / Q000517:prevention & control*; D004353:Drug Evaluation, Preclinical; D004352:Drug Resistance, Microbial; D006801:Humans; D012835:Silver Nitrate / Q000627:therapeutic use*; D012837:Silver Sulfadiazine / Q000627:therapeutic use*; D013997:Time Factors; D014946:Wound Infection / Q000382:microbiology / Q000517:prevention & control*
D000891:Anti-Infective Agents, Local; D012835:Silver Nitrate; D012837:Silver Sulfadiazine