Wound management in an era of increasing bacterial antibiotic resistance: A role for topical silver treatment

Background: Antibiotic-resistant bacteria represent an increasing concern i n wound infections. Wound colonization with these organisms normally result s in aggressive management of the wound complicated by a greatly limited ch oice of therapeutic antibiotics. Silver and other noble metals are recogniz ed as potential allies in combating these organisms in wounds, Methods: Three types of topical silver applications were tested to determin e their bactericidal efficacies against clinical isolates of antibiotic-res istant organisms. The silver-based applications represent 3 methods of appl ying silver to wounds: as a liquid (silver nitrate). incorporated in a crea m (silver sulfadiazine) and as a dressing coating (silver-coated dressings) . The reduction in the viable bacterial population recovered from test arti cles after exposure to silver provided a comparative measure of the bacteri cidal efficacies of these silver applications. Results: All of the products demonstrated an ability to reduce the number o f viable bacteria. However, the methods varied in their efficacy against an tibiotic-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 antibio tic-resistant strains tested. The silver-coated dressing was particularly r apid at killing the tested bacteria and was effective against a broader ran ge of bacteria. Silver may be a useful prophylactic or therapeutic agent fo r the prevention of wound colonization by organisms that impede healing, in cluding antibiotic-resistant bacteria.