Journal articles on the topic 'Wound antibiotic treatment'
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1
Caputo, Wayne J., Patricia Monterosa, and Donald Beggs. "Antibiotic Misuse in Wound Care: Can Bacterial Localization through Fluorescence Imaging Help?" Diagnostics 12, no. 12 (December 17, 2022): 3207. http://dx.doi.org/10.3390/diagnostics12123207.
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(1) Background: Systemic antibiotic use in chronic wounds is alarmingly high worldwide. Between 53% to 71% of patients are prescribed at least one course per chronic wound. Systemic antibiotic use should follow antibiotic stewardship guidelines and ought to be reserved for situations where their use is deemed supported by clinical indications. Unfortunately, in the field of wound care, indiscriminate and often inadequate use of systemic antibiotics is leading to both patient complications and worsening antibiotic resistance rates. Implementing novel tools that help clinicians prevent misuse or objectively determine the true need for systemic antibiotics is essential to reduce prescribing rates. (2) Methods: We present a compendium of available systemic antibiotic prescription rates in chronic wounds. The impact of various strategies used to improve these rates, as well as preliminary data on the impact of implementing fluorescence imaging technology to finesse wound status diagnosis, are presented. (3) Results: Interventions including feedback from wound care surveillance and treatment data registries as well as better diagnostic strategies can ameliorate antibiotic misuse. (4) Conclusions: Interventions that mitigate unnecessary antibiotic use are needed. Effective strategies include those that raise awareness of antibiotic overprescribing and those that enhance diagnosis of infection, such as fluorescence imaging.
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Polk, Hiram C., and A. Britton Christmas. "Prophylactic Antibiotics in Surgery and Surgical Wound Infections." American Surgeon 66, no. 2 (February 2000): 105–11. http://dx.doi.org/10.1177/000313480006600203.
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Wound infection remains a considerable cause of morbidity and mortality among surgical patients, despite the relative success of prophylactic antibiotics. In modern efforts to control healthcare costs while improving the quality of patient care, we must not overlook the basic principles of wound infections and their appropriate treatment. Predisposing factors for the development of surgical wound infection include the creation of a surgical wound, the presence of bacteria, and a susceptible host. The selection of an appropriate antimicrobial drug depends on the identification of the most likely pathogens associated with a given procedure, as well as the expected antibiotic susceptibility of those pathogens. Ideally, a prophylactic antibiotic should achieve high peak tissue concentration at the site of the wound before the first incision and should be maintained until the time of closure. Currently, the administration of prophylactic antibiotics is indicated for contaminated and clean-contaminated wounds. Despite the proven effectiveness of antibiotic prophylaxis, many researchers would argue that contemporary dosing regimens should be reevaluated. The debates concerning the dosage and timing of ideal prophylactic administration are likely to continue.
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Nowak, Marcela, and Wioletta Barańska-Rybak. "Nanomaterials as a Successor of Antibiotics in Antibiotic-Resistant, Biofilm Infected Wounds?" Antibiotics 10, no. 8 (August 4, 2021): 941. http://dx.doi.org/10.3390/antibiotics10080941.
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Chronic wounds are a growing problem for both society and patients. They generate huge costs for treatment and reduce the quality of life of patients. The greatest challenge when treating a chronic wound is prolonged infection, which is commonly caused by biofilm. Biofilm makes bacteria resistant to individuals’ immune systems and conventional treatment. As a result, new treatment options, including nanomaterials, are being tested and implemented. Nanomaterials are particles with at least one dimension between 1 and 100 nM. Lipids, liposomes, cellulose, silica and metal can be carriers of nanomaterials. This review’s aim is to describe in detail the mode of action of those molecules that have been proven to have antimicrobial effects on biofilm and therefore help to eradicate bacteria from chronic wounds. Nanoparticles seem to be a promising treatment option for infection management, which is essential for the final stage of wound healing, which is complete wound closure.
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Lovětinská-Šlamborová, Irena, Petr Holý, Petr Exnar, and Ivana Veverková. "Silica Nanofibers with Immobilized Tetracycline for Wound Dressing." Journal of Nanomaterials 2016 (2016): 1–6. http://dx.doi.org/10.1155/2016/2485173.
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Local antibiotic treatment has its justification for superficial infections. The advantage of this treatment is that the antibiotic has effects on bacterial agent directly at the application site. Skin infections which are intended for the local antibiotic treatment are superficial pyoderma, some festering wounds, burns of second and third degree, infected leg ulcers, or decubitus of second and third degree. Tetracyclines are available topical antibiotics with a broad bacterial spectrum. At present, ointments containing tetracycline are also used for the treatment, which rarely can lead to skin sensitization. In this paper, a development of novel nanofibrous material with immobilized tetracycline is presented. Two different methods of immobilized tetracycline quantification onto silica nanofibers are employed. It was proven that the prevailing part of tetracycline was bound weakly by physisorption forces, while the minor part was covalently bound by NH2groups formed by the preceding functionalization. The silica nanofibers with immobilized tetracycline are promising material for wound dressing applications due to its antibacterial activity; it was proved by tests.
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White, Terris L., Alfred T. Culliford, Martin Zomaya, Gary Freed, and Christopher P. Demas. "Use of Antibiotic-Impregnated Absorbable Beads and Tissue Coverage of Complex Wounds." American Surgeon 82, no. 11 (November 2016): 1068–72. http://dx.doi.org/10.1177/000313481608201121.
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The treatment of complex wounds is commonplace for plastic surgeons. Standard management is debridement of infected and devitalized tissue and systemic antibiotic therapy. In cases where vital structures are exposed within the wound, coverage is obtained with the use of vascularized tissue using both muscle and fasciocutaneous flaps. The use of nondissolving polymethylmethacrylate and absorbable antibiotic-impregnated beads has been shown to deliver high concentrations of antibiotics with low systemic levels of the same antibiotic. We present a multicenter retrospective review of all cases that used absorbable antibiotic-impregnated beads for complex wound management from 2003 to 2013. A total of 104 cases were investigated, flap coverage was used in 97 cases (93.3%). Overall, 15 patients (14.4%) required reoperation with the highest groups involving orthopedic wounds and sternal wounds. The advantages of using absorbable antibiotic-impregnated beads in complex infected wounds have been demonstrated with minimal disadvantages. The utilization of these beads is expanding to a variety of complex infectious wounds requiring high concentrations of local antibiotics.
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Stewart, Laveta, Ping Li, Maj Dana M. Blyth, Wesley R. Campbell, Joseph L. Petfield, Margot Krauss, Lauren Greenberg, and David R. Tribble. "Antibiotic Practice Patterns for Extremity Wound Infections among Blast-Injured Subjects." Military Medicine 185, Supplement_1 (January 2020): 628–36. http://dx.doi.org/10.1093/milmed/usz211.
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ABSTRACT Introduction We examined antibiotic management of combat-related extremity wound infections (CEWI) among wounded U.S. military personnel (2009–2012). Methods Patients were included if they sustained blast injuries, resulting in ≥1 open extremity wound, were admitted to participating U.S. hospitals, developed a CEWI (osteomyelitis or deep soft-tissue infections) within 30 days post-injury, and received ≥3 days of relevant antibiotic (s) for treatment. Results Among 267 patients, 133 (50%) had only a CEWI, while 134 (50%) had a CEWI plus concomitant non-extremity infection. In the pre-diagnosis period (4–10 days prior to CEWI diagnosis), 95 (36%) patients started a new antibiotic with 28% of patients receiving ≥2 antibiotics. During CEWI diagnosis week (±3 days of diagnosis), 209 (78%) patients started a new antibiotic (71% with ≥2 antibiotics). In the week following diagnosis (4–10 days after CEWI diagnosis), 121 (45%) patients started a new antibiotic with 39% receiving ≥2 antibiotics. Restricting to ±7 days of CEWI diagnosis, patients commonly received two (35%) or three (27%) antibiotics with frequent combinations involving carbapenem, vancomycin, and fluoroquinolones. Conclusions Substantial variation in antibiotic prescribing patterns related to CEWIs warrants development of combat-related clinical practice guidelines beyond infection prevention, to include strategies to reduce the use of unnecessary antibiotics and improve stewardship.
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Al-Naqshbandi, Ahmed A., Hedy A. Hassan, Mahmoud A. Chawsheen, and Haval H. Abdul Qader. "Categorization of Bacterial Pathogens Present in Infected Wounds and their Antibiotic Resistance Profile Recovered from Patients Attending Rizgary Hospital-Erbil." ARO-THE SCIENTIFIC JOURNAL OF KOYA UNIVERSITY 9, no. 2 (December 1, 2021): 64–70. http://dx.doi.org/10.14500/aro.10864.
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Wound infection with antibiotic-resistant bacteria can extend a patients’ debility and increase the expense of treatment in the long term; therefore, careful management of patients with wound infections is necessary to avoid complications. The usage of antimicrobial agent is a major factor in resistance development. This study aims to understand the causes of wound infections, as well as the criteria for diagnosing them for more sensible antibiotic prescribing. Samples from 269 wound patients were collected, and cultured for bacterial growth. Gram stain technique, bacterial identification via VITEK 2 compact system were investigated in this study. Gram negative bacteria accounted for 59.15% of the total isolates, while pathogenic gram positive bacteria accounted for 40.85% of total isolates. Escherichia coli and Pseudomonas aeruginosa are the dominant pathogenic gram negative bacteria in wounds, while Staphylococcus aureus, and Staphylococcus epidermidis are the dominant pathogenic gram positive bacteria. Pseudomonas aeruginosa showed 100% resistance to the majority of antibiotic tested, including Ampicillin, Amoxicillin/Clavulanic Acid, Aztreona, Ceftriaxone, and others. Staphylococcus aureus and Staphylococcus epidermidis are 100% resistant to Ampicillin, Ceftriaxone, and Cefotaxime. For more efficient antibiotic prescriptions, the causative microorganisms, and their current susceptibility patterns need to be mandated for testing before prescribing any antibiotics to patients. Prescriptions are frequently based solely on general information about the antibiotic's function, rather than on individual response variation to the pathogen and the antibiotic. Particularly when the common pathogens in this study show multidrug resistance in wounds.
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Goulart, Débora Brito. "The use of silver hydrogel in wound treatment as an alternative to reduce antibiotic-resistant pathogens." Research, Society and Development 11, no. 12 (September 18, 2022): e387111234849. http://dx.doi.org/10.33448/rsd-v11i12.34849.
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Medical science is currently at an early stage for effectively controlling skin damage. One of the main barriers to good wound healing is bacterial infection, which poses a risk of long-term harmful effects. A clean wound, free of bacterial infections, is essential for the quick and effective regeneration of the skin. Hydrogel is one of the best biomaterials for antibiotic delivery in wound areas due to its high hydrophilicity, distinctive three-dimensional network, good biocompatibility, and cell adherence. Although many antibiotics are successful in treating infected wounds, improper or repetitive use of these medications may cause germs to become resistant. Notoriously, antimicrobial resistance in pathogenic bacteria is already considered a serious global public health issue. Recently, the use of silver associated with nanotechnology has been reconsidered as an important alternative to reduce the spread of antibiotic-resistant pathogens. Silver hydrogel dressings have become effective agents in wound management, substituting the use of antibiotics. The objective of this review is to show the importance of hydrogels in wound treatments, as well as the antibacterial properties of silver hydrogels and their implications in wound care.
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Cross, S. E., M. J. Thompson, and M. S. Roberts. "Distribution of systemically administered ampicillin, benzylpenicillin, and flucloxacillin in excisional wounds in diabetic and normal rats and effects of local topical vasodilator treatment." Antimicrobial Agents and Chemotherapy 40, no. 7 (July 1996): 1703–10. http://dx.doi.org/10.1128/aac.40.7.1703.
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The present study assessed the suitability of the streptozotocin-treated diabetic rat as a model for the study of diabetes-impaired wound healing. The distribution of three antibiotics, ampicillin, benzylpenicillin, and flucloxacillin, in wound and adjacent tissue sites on the abdomens and legs of normal and diabetic rats was determined 30 min after intravenous administration of a single bolus containing 50 mg of all three antibiotics per kg of body weight. Tissue/plasma ratios showed that antibiotic tissue penetration appeared to be related to protein binding. The treatment of wound sites with vasodilators (1% solution) to increase local blood flow and antibiotic delivery to the site was then determined and appeared to be more effective with endothelium-independent sodium nitroprusside than with endothelium-dependent acetylcholine in diabetic rats. These results suggest that coadministration of topical vasodilators to wound sites in neuropathic diabetic patients undergoing antibiotic therapy for infected ulcers could increase antibiotic delivery to wound tissue sites.
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Dallo, Matthew, Kavina Patel, and Adelaide A. Hebert. "Topical Antibiotic Treatment in Dermatology." Antibiotics 12, no. 2 (January 17, 2023): 188. http://dx.doi.org/10.3390/antibiotics12020188.
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Many indications in dermatology can be effectively managed with topical antibiotics, including acne vulgaris, wound infections, secondarily infected dermatitis, and impetigo. Dermatologists must be familiar with the wide spectrum of topical antibiotics available, including indications, mechanisms of action, adverse events, and spectra of activity. Dermatologists must also keep antibiotic resistance in mind when utilizing these medications. Due to the widespread use of topical antibiotics and their importance in dermatology, a literature review was performed using a systematic search of PubMed and Google Scholar with the terms topical antibiotics, skin infections, dermatology, antimicrobials, and inflammatory dermatoses to identify English-language articles published between 1965–2022 from any country. Relevant publications were manually reviewed for additional content. The following literature review will summarize the common topical antibiotics used in dermatology.
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Souto, Eliana B., André F. Ribeiro, Maria I. Ferreira, Maria C. Teixeira, Andrea A. M. Shimojo, José L. Soriano, Beatriz C. Naveros, et al. "New Nanotechnologies for the Treatment and Repair of Skin Burns Infections." International Journal of Molecular Sciences 21, no. 2 (January 8, 2020): 393. http://dx.doi.org/10.3390/ijms21020393.
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Burn wounds are highly debilitating injuries, with significant morbidity and mortality rates worldwide. In association with the damage of the skin integrity, the risk of infection is increased, posing an obstacle to healing and potentially leading to sepsis. Another limitation against healing is associated with antibiotic resistance mainly due to the use of systemic antibiotics for the treatment of localized infections. Nanotechnology has been successful in finding strategies to incorporate antibiotics in nanoparticles for the treatment of local wounds, thereby avoiding the systemic exposure to the drug. This review focuses on the most recent advances on the use of nanoparticles in wound dressing formulations and in tissue engineering for the treatment of burn wound infections.
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Edwards-Jones, Val. "Antimicrobial stewardship in wound care." British Journal of Nursing 29, no. 15 (August 13, 2020): S10—S16. http://dx.doi.org/10.12968/bjon.2020.29.15.s10.
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Strategies to tackle the global crisis of antimicrobial resistance include implementing antimicrobial stewardship across the healthcare and agricultural sectors. Many clinical specialities have developed policies to advise practitioners on how to prescribe antibiotics more effectively, but there is still a lack of data on the impact of this change. Overuse and misuse of antibiotics have been commonplace since their introduction 70 years ago, and have contributed to the development of the resistance seen today. There is a dearth of new antibiotics and, if nothing is done to restrict the use of those that remain effective, there is a risk of returning to the pre-antibiotic era where simple infections could result in death. In wound care, it is essential that antibiotic treatment is appropriate to reduce infections. Many medical conditions predispose people to wounds that are difficult to heal and become chronic unless the underlying causes are addressed. Most wound infections are caused by bacteria, which are becoming increasingly resistant to commonly used antibiotics. This necessitates strict regimens for managing infection, which include prescribing antibiotics only when they are essential. Antimicrobial stewardship is undertaken in all UK healthcare facilities, and local advisory committees oversee the prudent use of antibiotics and other antimicrobial agents to try to prevent further increases in resistance. National guidance has been produced but whether full compliance has been followed has yet to be established and the impact of implementation needs to be analysed.
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Bowler, P. G., B. I. Duerden, and D. G. Armstrong. "Wound Microbiology and Associated Approaches to Wound Management." Clinical Microbiology Reviews 14, no. 2 (April 1, 2001): 244–69. http://dx.doi.org/10.1128/cmr.14.2.244-269.2001.
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SUMMARY The majority of dermal wounds are colonized with aerobic and anaerobic microorganisms that originate predominantly from mucosal surfaces such as those of the oral cavity and gut. The role and significance of microorganisms in wound healing has been debated for many years. While some experts consider the microbial density to be critical in predicting wound healing and infection, others consider the types of microorganisms to be of greater importance. However, these and other factors such as microbial synergy, the host immune response, and the quality of tissue must be considered collectively in assessing the probability of infection. Debate also exists regarding the value of wound sampling, the types of wounds that should be sampled, and the sampling technique required to generate the most meaningful data. In the laboratory, consideration must be given to the relevance of culturing polymicrobial specimens, the value in identifying one or more microorganisms, and the microorganisms that should be assayed for antibiotic susceptibility. Although appropriate systemic antibiotics are essential for the treatment of deteriorating, clinically infected wounds, debate exists regarding the relevance and use of antibiotics (systemic or topical) and antiseptics (topical) in the treatment of nonhealing wounds that have no clinical signs of infection. In providing a detailed analysis of wound microbiology, together with current opinion and controversies regarding wound assessment and treatment, this review has attempted to capture and address microbiological aspects that are critical to the successful management of microorganisms in wounds.
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Shah, Amit, Bharat Gajjar, and Ravi Shankar. "Antibiotic Utilization for Surgical Prophylaxis in a Tertiary Care Teaching Rural Hospital." International Journal of User-Driven Healthcare 1, no. 4 (October 2011): 1–14. http://dx.doi.org/10.4018/ijudh.2011100101.
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Rational antibiotic prophylaxis reduces the incidence of surgical wound infection. Improper antibiotic prophylaxis leads to excessive surgical wound infection and increased drug resistance. There is an urgent need to establish and implement antibiotic policy but it cannot be done if baseline data is not available. In this study, the authors gathered baseline data about the pattern of surgical antibiotic prophylaxis in their institute. They found that most of the perioperative use of antibiotics was not as per standard guidelines in terms of choice of antibiotics and total duration of treatment. Interventions are warranted to promote the development, dissemination, and adoption of evidence-based guidelines for antibiotic surgical prophylaxis.
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Spille, Johannes, Juliane Schulz, Dorothee Cäcilia Spille, Hendrik Naujokat, Henning Wieker, Jörg Wiltfang, and Aydin Gülses. "Microbiological Characteristics and Surgical Management of Animal-Bite-Related Oral & Maxillofacial Injuries: A Single Center’s Experience." Antibiotics 10, no. 8 (August 18, 2021): 998. http://dx.doi.org/10.3390/antibiotics10080998.
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The objective of the current study is to retrospectively evaluate animal-bite injuries and to gain insight into the epidemiology, accident consequences and treatment concept of these accidents in oral and maxillofacial surgery. Data of patients, who were admitted January 2015 and April 2021, were retrospectively evaluated regarding the patients’ characteristics (age, gender), facial distribution of substance defects/partial amputations, duration of hospitalization, operation treatments and antibiotic treatments. Data of 75 patients were included. Patients were bitten by dogs (n = 69.92%), cats (n = 4) and horses (n = 2). Lower eyelid/cheek complex was the most affected region (n = 37, 32.74%). Most of the patients between 0 and 3 years had to be operated on under general anesthesia (p = 0.011), while most of the adults could be operated on under local anesthesia (p = 0.007). In the age group 0–12 years, 30 patients (68%) were operated on under general anesthesia. Ampicillin/Sulbactam (48%) was the antibiotic most used. Antibiotics were adjusted after wound swabs in case of wound infections or critical wound conditions. This means that resistant antibiotics were stopped, and sensitive antibiotics were used. Structured surgical and antibiotic management of animal-bite wounds in the maxillofacial region is the most important factor for medical care to avoid long-term aesthetic consequences. Public health actions and policies under the leadership of an interdisciplinary committee could improve primary wound management, healing outcome and information status in the general population.
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Saldanha, Jovita, Chethan Kumar GS, Kushal Shah, Suhas Abhyankar, and Arvind M. Vartak. "Antibiogram of burn wound isolates at Masina hospital, Mumbai, India: A 12-year descriptive cross sectional study." IP International Journal of Medical Microbiology and Tropical Diseases 8, no. 1 (February 15, 2022): 29–36. http://dx.doi.org/10.18231/j.ijmmtd.2022.007.
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: To study the antibiogram of Klebsiella, Pseudomonas and Staphylococcus and its change in sensitivities with time. : 4909 swabs were taken from790 of patients admitted to the Burns unit of Masina Hospital, Mumbai, over a period of 12 years (2008–2019). The swabs were cultured and percentage antibiotic sensitivity of 6835 predominate isolates to different class of antibiotic was determined and reviewed. : Klebsiella was the predominant organism in our set-up, followed by Pseudomonas and Staphylococcus aureus. The antibiotic sensitivities of the most predominant organisms are discussed in detail in this article. : Gram negative nosocomial infection predominate a burn injury. Knowing the predominant target pathogens and their sensitivity pattern towards different antibiotics will avoid misuse of antibiotic, contribute to prescribing the correct antibiotics and timely clinical treatment. A routine microbiological surveillance prior to administrating an antibiotic, a well established infection control department and regular reporting of changing antibiotic trends will help us overcome our battle against emerging multi drug resistant organism, thereby having more successful treatment outcome in burn patients.
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Holubová, Adéla, Lucie Chlupáčová, Lada Cetlová, Niels A. J. Cremers, and Andrea Pokorná. "Medical-Grade Honey as an Alternative Treatment for Antibiotics in Non-Healing Wounds—A Prospective Case Series." Antibiotics 10, no. 8 (July 28, 2021): 918. http://dx.doi.org/10.3390/antibiotics10080918.
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Non-healing wounds are usually colonised by various types of bacteria. An alternative to antibiotic treatment in patients with infected wounds with local signs of inflammation may be medical-grade honey (MGH), which favourably affects the healing process with its antimicrobial, antioxidant, anti-inflammatory, and immunomodulatory properties. The objective of this study was to evaluate the effect of MGH therapy on the healing process of non-healing wounds of various aetiologies and different wound colonisations. Prospective, observation–intervention case studies (n = 9) of patients with wounds of various aetiologies (venous leg ulcers, diabetic foot ulcers, surgical wound dehiscence) are presented. All wounds were treated with MGH and the healing trajectory was rigorously and objectively monitored. In all cases, pain, odour, and exudation were quickly resolved, which led to an improvement in the quality of life of patients. Despite the proven bacterial microflora in wounds, antibiotic treatment was not necessary. The effects of MGH alleviated the signs of local infection until their complete elimination. In eight out of nine cases, the non-healing wound was completely healed. MGH has antimicrobial, anti-inflammatory, and antioxidant effects in wounds of various aetiologies and forms an effective alternative for the use of antibiotics for treating locally infected wounds.
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Pinto, Ana M., Miguel A. Cerqueira, Manuel Bañobre-Lópes, Lorenzo M. Pastrana, and Sanna Sillankorva. "Bacteriophages for Chronic Wound Treatment: From Traditional to Novel Delivery Systems." Viruses 12, no. 2 (February 20, 2020): 235. http://dx.doi.org/10.3390/v12020235.
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The treatment and management of chronic wounds presents a massive financial burden for global health care systems, with significant and disturbing consequences for the patients affected. These wounds remain challenging to treat, reduce the patients’ life quality, and are responsible for a high percentage of limb amputations and many premature deaths. The presence of bacterial biofilms hampers chronic wound therapy due to the high tolerance of biofilm cells to many first- and second-line antibiotics. Due to the appearance of antibiotic-resistant and multidrug-resistant pathogens in these types of wounds, the research for alternative and complementary therapeutic approaches has increased. Bacteriophage (phage) therapy, discovered in the early 1900s, has been revived in the last few decades due to its antibacterial efficacy against antibiotic-resistant clinical isolates. Its use in the treatment of non-healing wounds has shown promising outcomes. In this review, we focus on the societal problems of chronic wounds, describe both the history and ongoing clinical trials of chronic wound-related treatments, and also outline experiments carried out for efficacy evaluation with different phage-host systems using in vitro, ex vivo, and in vivo animal models. We also describe the modern and most recent delivery systems developed for the incorporation of phages for species-targeted antibacterial control while protecting them upon exposure to harsh conditions, increasing the shelf life and facilitating storage of phage-based products. In this review, we also highlight the advances in phage therapy regulation.
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Yun, Tery, Soeun Shin, Kyungwon Bang, Mugeun Lee, Jung-Ah Cho, and Myungin Baek. "Skin Wound Healing Rate in Fish Depends on Species and Microbiota." International Journal of Molecular Sciences 22, no. 15 (July 21, 2021): 7804. http://dx.doi.org/10.3390/ijms22157804.
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The skin is a barrier between the body and the environment that protects the integrity of the body and houses a vast microbiota. By interacting with the host immune system, the microbiota improves wound healing in mammals. However, in fish, the evidence of the role of microbiota and the type of species on wound healing is scarce. We aimed to examine the wound healing rate in various fish species and evaluate the effect of antibiotics on the wound healing process. The wound healing rate was much faster in two of the seven fish species selected based on habitat and skin types. We also demonstrated that the composition of the microbiome plays a role in the wound healing rate. After antibiotic treatment, the wound healing rate improved in one species. Through 16S rRNA sequencing, we identified microbiome correlates of varying responses on wound healing after antibiotic treatment. These findings indicate that not only the species difference but also the microbiota play a significant role in wound healing in fish.
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Tzaneva, Valentina, Irena Mladenova, Galina Todorova, and Dimitar Petkov. "Antibiotic treatment and resistance in chronic wounds of vascular origin." Medicine and Pharmacy Reports 89, no. 3 (July 31, 2016): 365–70. http://dx.doi.org/10.15386/cjmed-647.
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Background and aim. The problem of antibiotic resistance is worldwide and affects many types of pathogens. This phenomenon has been growing for decades and nowadays we are faced with a wide range of worrisome pathogens that are becoming resistant and many pathogens that may soon be untreatable. The aim of this study was to determine the resistance and antibiotic treatment in chronic wounds of vascular origin.Methods. We performed a cross sectional study on a sample of patients with chronic vascular wounds, hospitalized between October 2014 and August 2015, in the Clinic of Vascular Surgery in Trakia Hospital Stara Zagora. The statistical analysis of data was descriptive, considering the p value of ≤0.05, the threshold of statistical significance.Results. In the group of 110 patients, the significantly most frequent chronic wound (p<0.001) was peripheral arteriopathy (47.3%, CI95%: 38.19-56.54). Among 159 strains, 30% of patients having multiple etiology, the species most frequently isolated were Staphylococcus aureus, E.coli, Enterococcus faecalis, Pseudomonas aeruginosa and Proteus mirabilis with a significant predominance (p<0.05) of the Gram negative (55.1%). The spectrum of strains resistance included the Beta-lactams (36.4%, p<0.001), Macrolides (20%), Tetracyclines (9.1%), Aminoglycosides (8.2%) and Fluoroquinolones (4.5%).Conclusions. Gram negative microorganisms were the main isolates in patients with vascular chronic wound. Significantly predominant was the resistance to the beta-lactam antibiotics.
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Helary, Christophe, Aicha Abed, Gervaise Mosser, Liliane Louedec, Didier Letourneur, Thibaud Coradin, Marie Madeleine Giraud-Guille, and Anne Meddahi-Pellé. "Evaluation of dense collagen matrices as medicated wound dressing for the treatment of cutaneous chronic wounds." Biomaterials Science 3, no. 2 (2015): 373–82. http://dx.doi.org/10.1039/c4bm00370e.
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Ahmad, Shabbir, Mudassar Nazar, Yusuf-Bin Tahir, Fazal-E. Nauman, Abdul Qayum Baig, and Muhammad Adeel-ur Rehman. "A Comparative Study of Antibiotic Therapy with and without Bone Debridement in Diabetic Foot Osteomyelitis." Pakistan Journal of Medical and Health Sciences 15, no. 12 (December 30, 2021): 3805–7. http://dx.doi.org/10.53350/pjmhs2115123805.
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Objective: To compare the outcomes of antibiotic therapy with and without bone debridement in diabetic foot osteomyelitis (DFO) patients. Methods: The surgical and orthopaedics Units of Islam Medical College conducted a prospective randomized comparison study on 100 diabetic individuals with DFO between January 1, 2020, and June-2021. Patients were separated into two groups: those who got just antibiotic therapy and those who had debridement and/or contemporaneous minor amputation. Three outcome indicators were evaluated between treatment groups: hospitalization time, antibiotic therapy time, and wound healing time. Results: Patient’s demographics e.g., age, BMI and gender were almost similar among groups. The hospital stay duration was 39.7±18.4 days in antibiotic versus 43.4±23.9 days in the combination group. Duration of antibiotics was 42.8±15.6 days in the antibiotic group versus 45.3±18.0 days in the combination group (p-value 0.45). Mean duration of wound healing was 230.8±120.8 days in antibiotic group versus 217.1±95.3 days in combination group (p-value 0.53). Conclusion: Our study has demonstrated comparable outcomes amongst individuals who got antibiotic treatment alone and those who had debridement and/or contemporaneous minor amputations. Keywords: diabetic foot osteomyelitis (DFO), Antibiotics, amputation.
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Binning, TA, JM Karlin, D. Klein, BL Scurran, and RA Cooke. "Ciprofloxacin in the treatment of Mycobacterium fortuitum infection of the peroneal tendons. A case report." Journal of the American Podiatric Medical Association 82, no. 7 (July 1, 1992): 382–85. http://dx.doi.org/10.7547/87507315-82-7-382.
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In the case reported, M. fortuitum was sensitive in vitro to amikacin, erythromycin, tobramycin, and ciprofloxacin. Because the patient did not respond to long-term therapy with amikacin and erythromycin, an experimental antibiotic, ciprofloxacin, was tried. Only after extensive surgical debridement and 2 1/2 months of oral ciprofloxacin therapy was the infection eradicated and wound healing obtained. The authors conclude that a wound that has reopened, but remains indolent, exudes a clear, serous drainage and responds poorly to antibiotics should suggest a possible mycobacterial infection. Combination antibiotic therapy is recommended because of the high rate of relapse and development of resistance to drugs. Extensive surgical debridement of all infected tissue remains the primary treatment. The therapeutic value of ciprofloxacin and other newer antibiotics in the treatment of mycobacterial infection is promising.
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Peterson, Charles D., Kathleen D. Lake, Kit V. Arom, and Kathryn R. Love. "Antibiotic Prophylaxis in Open-Heart Surgery Patients: Comparison of Cefamandole and Cefuroxime." Drug Intelligence & Clinical Pharmacy 21, no. 9 (September 1987): 728–32. http://dx.doi.org/10.1177/106002808702100912.
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The efficacy of cefamandole and cefuroxime in preventing postoperative wound infections was compared in 3037 patients undergoing open-heart surgery. Antibiotic prophylaxis in 1467 patients having coronary artery bypass and valve replacement surgery was cefamandole 2 g iv preoperatively followed by 2 g q6h for five days postoperatively; 1570 patients received cefuroxime 1.5 g iv preoperatively then 1.5 g iv q12h for threedays postoperatively. Postoperative wound infections (sternal and leg wounds) were studied in each treatment group. In the cefamandole study group, 27 patients (1.8 percent) developed postoperative wound infections (9 sternal and 18 leg wounds). In the cefuroxime treatment group, 19 patients (1.2 percent) developed postoperative wound infections (9 sternal and 10 leg wounds). Overall, no statistical difference was found between the two antibiotics in preventing postoperative wound infections. However, in patients having valve replacement surgery, cefuroxime was found statistically more effective than cefamandole prophylaxis in preventing sternal wound infections (no infections in 284 patients compared with five infections in 205 patients, respectively, p = 0.01). The most common organism isolated from infected wounds with cefamandole was Staphylococcus aureus followed by S. epidermidis compared with cefuroxime which had S. epidermidis followed by S. aureus. Cefuroxime was found to be as effective as cefamandole and considerably less expensive in preventing postoperative wound infections in patients undergoing open-heart surgery.
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Ngui, L. X., L. S. Wong, G. Shashi, and M. N. Abu Bakar. "Facial carbuncle – a new method of conservative surgical management plus irrigation with antibiotic-containing solution." Journal of Laryngology & Otology 131, no. 9 (April 17, 2017): 830–33. http://dx.doi.org/10.1017/s0022215117000834.
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AbstractObjective:This paper reports on a non-conventional method for the management of facial carbuncles, highlighting its superiority over conventional surgical treatment in terms of cosmetic outcome and shorter duration of wound healing.Background:The mainstay of treatment for carbuncles involves the early administration of antibiotics in combination with surgical intervention. The conventional saucerisation, or incision and drainage, under normal circumstances results in moderate to large wounds, which may need secondary surgery such as skin grafting, resulting in a longer duration of wound healing and jeopardising cosmetic outcome.Case reports:The reported three cases presented with extensive carbuncles over the chin, face and lips region. In addition to early commencement of intravenous antibiotics, the pus was drained, with minimal incision and conservative wound debridement, with the aim of maximal skin conservation. This was followed by thrice-daily irrigation with antibiotic-containing solution for a minimum of 2 consecutive days. The wounds healed within two to four weeks, without major cosmetic compromise.Conclusion:The new method showed superior cosmetic outcomes, with a shorter duration of wound healing. Conservative surgical management can be performed under regional anaesthesia, which may reduce morbidity and mortality; patients with facial carbuncles often have higher risks with general anaesthesia.
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Hewett, Samantha R., Stephany D. Crabtrey, Esther E. Dodson, C. Alexander Rieth, Richard M. Tarkka, and Kari Naylor. "Both Manuka and Non-Manuka Honey Types Inhibit Antibiotic Resistant Wound-Infecting Bacteria." Antibiotics 11, no. 8 (August 20, 2022): 1132. http://dx.doi.org/10.3390/antibiotics11081132.
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Postoperative infections are a major concern in United States hospitals, accounting for roughly 20% of all hospital-acquired infections yearly. Wound-infecting bacteria, in particular, have a high rate of drug resistance (up to 65%), creating life-threatening complications. Manuka honey, native to New Zealand, has been FDA-approved for wound treatment in the United States after studies demonstrated its ability to inhibit a variety of bacterial species and facilitate wound healing. The aim of this study was to identify alternative (non-manuka) honey types that can be specifically used against antibiotic resistance bacteria in wound infections. We utilized a honey-plate method to measure the minimum inhibitory concentration (MIC) of honey to avoid the limitations of agar diffusion, where large, nonpolar polyphenols (which will not diffuse efficiently) play an important role in bioactivity. This study demonstrated that there are several alternative (non-manuka) honey types, particularly fresh raw Arkansas wildflower honeys, that comparably inhibit the growth of the antibiotic-resistant bacterial species specifically implicated in wound infections. Concentrations of 10–30% honey inhibited the growth of the highly antibiotic-resistant organisms colloquially referred to as “superbugs”, which the WHO declared in 2017 to be in critical need of new antibiotics. There was no statistical difference between manuka honey and fresh summer Arkansas wildflower honey in overall bacterial inhibition. These results could transform wound care in the United States, where manuka honey can be expensive and difficult to obtain and where antibiotic resistance remains a troubling concern for wound treatment.
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Noskiewicz, Jakub, Paweł Juszczak, Małgorzata Rzanny- Owczarzak, and Przemysław Mańkowski. "Antibiotic therapy and infection complications in paediatric burn injuries." Postępy Higieny i Medycyny Doświadczalnej 73 (May 15, 2019): 1–8. http://dx.doi.org/10.5604/01.3001.0013.2019.
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Background: Each year, nearly 1% of population suffers from burn injuries. The main cause of complications and death after thermal injury is infections. Excessive use of antibiotics affects however the children treated for burns and can have negative effects. Therefore, specifying the recommendations for antibiotic therapy in patients after thermal injury seems to be of importance. Materials and methods: An evaluation of 310 paediatric patients hospitalised for burn injuries was performed. In the first part of evaluation, a retrospective analysis of treatment with particular focus on infection complications and administered antibiotics was performed. This was followed by a prospective evaluation of effectiveness of the principles of antibiotic therapy specified at the earlier stage. Results: In 2010-2016, an antibiotic was systemically administered to 53.4% of children treated for thermal injury, provided that in 87.1% of cases it was introduced as a prophylactic measure. Infection of a burn wound was recorded in 4.7% of cases. The most frequently isolated bacterium (57.1%) was Staphylococcus aureus MSSA. Supply of antibiotics failed to reduce the number of infection complications or burn wound infections. The studies formed the basis for specification of the internal antibiotic therapy criteria, effectiveness of which was then evaluated. In 2017, an antibiotic was administered to 37.1% of patients. Reducing antibiotic therapy did not increase the risk of infection complications or frequency of wound infections. Conclusion: Routine antibiotic prophylaxis in burn injuries has no effect on the risk of infection complications and does not reduce the treatment time. It should be limited to perioperative prophylaxis in the case of skin grafts and to the patients with progressing symptoms of burn disease or with concomitant infections.
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Harahsheh, B., B. Hiyasat, A. Abulail, and M. Al Basheer. "Management of wound infection after appendectomy: are parenteral antibiotics useful?" Eastern Mediterranean Health Journal 8, no. 4-5 (August 31, 2021): 638–44. http://dx.doi.org/10.26719/2002.8.4-5.638.
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This study investigated the use of antibiotics in the treatment of wound infections after appendectomy. The subjects were 72 patients with post-operative wound infections at a district general hospital in Jordan. All patients received daily antiseptic dressings with povidone-iodine 10% in alcohol. The patients were randomized in a single-blind trial to receive either no antibiotics or parenteral antibiotics metronidazole and cefoxitin. There was no significant effect of antibiotic use in patients with early inflamed or severely inflamed appendicitis. However, for patients with perforated appendicitis the mean length of hospital stay and the mean frequency of change of dressings were significantly reduced. We conclude that antibiotics do not offer any advantage in post-appendectomy wound infections except for cases of perforated appendix
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Engeman, Emily, Helen R. Freyberger, Brendan W. Corey, Amanda M. Ward, Yunxiu He, Mikeljon P. Nikolich, Andrey A. Filippov, Stuart D. Tyner, and Anna C. Jacobs. "Synergistic Killing and Re-Sensitization of Pseudomonas aeruginosa to Antibiotics by Phage-Antibiotic Combination Treatment." Pharmaceuticals 14, no. 3 (February 25, 2021): 184. http://dx.doi.org/10.3390/ph14030184.
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Multidrug-resistant (MDR) Pseudomonas aeruginosa infections pose a serious health threat. Bacteriophage–antibiotic combination therapy is a promising candidate for combating these infections. A 5-phage P. aeruginosa cocktail, PAM2H, was tested in combination with antibiotics (ceftazidime, ciprofloxacin, gentamicin, meropenem) to determine if PAM2H enhances antibiotic activity. Combination treatment in vitro resulted in a significant increase in susceptibility of MDR strains to antibiotics. Treatment with ceftazidime (CAZ), meropenem, gentamicin, or ciprofloxacin in the presence of the phage increased the number of P. aeruginosa strains susceptible to these antibiotics by 63%, 56%, 31%, and 81%, respectively. Additionally, in a mouse dorsal wound model, seven of eight mice treated with a combination of CAZ and PAM2H for three days had no detectable bacteria remaining in their wounds on day 4, while all mice treated with CAZ or PAM2H alone had ~107 colony forming units (CFU) remaining in their wounds. P. aeruginosa recovered from mouse wounds post-treatment showed decreased virulence in a wax worm model, and DNA sequencing indicated that the combination treatment prevented mutations in genes encoding known phage receptors. Treatment with PAM2H in combination with antibiotics resulted in the re-sensitization of P. aeruginosa to antibiotics in vitro and a synergistic reduction in bacterial burden in vivo.
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Zieliński, Ewa, Kinga Grobelska, Piotr Dzięgielewski, and Romuald Olszański. "Treatment of a Chronic Wound - A Case Report of a Patient Treated at the Centre for Hyperbaric Oxygen and Treatment of Wounds in Bydgoszcz." Polish Hyperbaric Research 63, no. 2 (June 1, 2018): 22–25. http://dx.doi.org/10.2478/phr-2018-0011.
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Abstract This paper presents a case report of a patient with a diagnosed complication of a sternum wound which was treated using hyperbaric oxygen, emphasizing the truism of the benefits of combined surgical therapy, antibiotic therapy and oxybarotherapy.
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Nair, Harikrishna K. R., Nektarios Tatavilis, Ivana Pospíšilová, Jana Kučerová, and Niels A. J. Cremers. "Medical-Grade Honey Kills Antibiotic-Resistant Bacteria and Prevents Amputation in Diabetics with Infected Ulcers: A Prospective Case Series." Antibiotics 9, no. 9 (August 19, 2020): 529. http://dx.doi.org/10.3390/antibiotics9090529.
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Diabetic ulcers are at risk of becoming chronic and infected, as diabetics have hampered vascular structures, limiting oxygen and nutrient supply. These wounds can lead to pain, malodor, functional problems, and amputation. The current rise in antibiotic resistance demands for complementary therapies. Medical-grade honey (MGH) forms an attractive option because of its antimicrobial and pro-healing properties. We aim to show the beneficial effects of MGH in infected diabetic ulcers. We present six patients with infected diabetic ulcers, of which some were at risk of (further) amputation. Previous treatments with antibiotics, silver and alginate dressings, surgical closure, and maggot therapy were ineffective; therefore, the treatment was switched to the application of MGH. MGH therapy typically reduced the malodor in a couple of days and controlled infection within 2–3 weeks. MGH also enhanced wound healing by promoting granulation tissue formation, angiogenesis, and re-epithelialization, by decreasing inflammatory and oxidative stress and providing nutrients. Together, wound healing was enhanced, and the patient’s quality of life improved. MGH is safe and cost-effective for treating complicated diabetic wounds with (antibiotic-resistant) infections and at risk of amputation. MGH forms a promising alternative or complementary therapy to replace antibiotics for treating locally infected wounds.
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McArdle, Carla D., Katie M. Lagan, and David A. McDowell. "Effects of pH on the Antibiotic Resistance of Bacteria Recovered from Diabetic Foot Ulcer Fluid." Journal of the American Podiatric Medical Association 108, no. 1 (January 1, 2018): 6–11. http://dx.doi.org/10.7547/16-033.
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Background: This study investigated the resistance of bacteria isolated from diabetic foot ulcers (DFUs) to antibiotics frequently used in the management of the diabetic foot infections, at a range of pH values (pH 6.5, 7.5, and 8.5) known to exist in DFU wound fluid. This study aimed to determine whether changes (or atypical stasis) in wound fluid pH modulate the antibiotic resistance of DFU isolates, with potential implications in relation to the suppression/eradication of bacterial infections in DFUs. Methods: Thirty bacterial isolates were recovered from DFU wound fluid, including Staphylococcus spp, Staphylococcus aureus, Escherichia coli, Streptococcus spp, Pseudomonas spp, and Pseudomonas aeruginosa. The resistances of these isolates to a panel of antibiotics currently used in the treatment of infected or potentially infected DFUs, ie, ciprofloxacin, amoxicillin-clavulanate, doxycycline, and piperacillin-tazobactam, at the previously mentioned pH values were determined by a modification of the Kirby-Bauer assay. Results: The resistance of DFU isolates to clinically relevant antibiotics was significantly affected by the pH levels in DFU wound fluid. Conclusions: These findings highlight the importance of a more comprehensive understanding of the conditions in DFUs to inform clinical decision making in the selection and application of antibiotics in treating these difficult-to-heal wounds. The scale of the differences in the efficacies of antibiotics at the different pH values examined is likely to be sufficient to suggest reconsideration of the antibiotics of choice in the treatment of DFU infection.
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Baranek, Eric S., Direk Tantigate, Eugene Jang, Justin K. Greisberg, and J. Turner Vosseller. "Time to Diagnosis and Treatment of Surgical Site Infections in Foot and Ankle Surgery." Foot & Ankle International 39, no. 9 (May 18, 2018): 1070–75. http://dx.doi.org/10.1177/1071100718777468.
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Background: The time at which patients typically present with surgical site infections (SSI) following foot and ankle surgery has not been characterized. The primary aim of this study was to quantify the time to definitive treatment of SSIs. Methods: We performed a retrospective review of 1933 foot and ankle procedures in 1632 patients from 2011 through 2015. Demographic and surgical data were collected. Time to presentation in cases diagnosed with postoperative wound complications or SSIs was analyzed. Wound complications were defined as any case with concerning wound appearance that subsequently resolved with antibiotic therapy alone. SSIs were defined as cases requiring operative irrigation and debridement (I&D) for successful definitive management. Results: A total of 1569 procedures met inclusion criteria, with 17 SSIs (1.1%) and 63 wound complications (4.0%). Time between surgery and definitive treatment in the SSI group was significantly greater than in the wound complication group (28.2 ± 9.1 vs 13.4 ± 4.7 days, P < .00001). Eleven (64.7%) cases in the SSI group failed a trial of antibiotics prior to I&D, and 6 (35.3%) cases did not receive antibiotics prior to I&D. Antibiotic treatment prior to I&D did not significantly decrease the yield of intraoperative wound cultures (70% vs 100%, P = .51). Conclusion: In our cohort of patients, the time to diagnosis and treatment of SSIs was longer than that of wound complications. SSIs requiring operative intervention did not present until an average of 4 weeks after surgery. These data are of some benefit in trying to define and understand SSI. Level of Evidence: Level III, retrospective cohort study.
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Zyman, Anna, Andrzej Górski, and Ryszard Międzybrodzki. "Phage therapy of wound-associated infections." Folia Microbiologica 67, no. 2 (January 13, 2022): 193–201. http://dx.doi.org/10.1007/s12223-021-00946-1.
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AbstractPhages are viruses which can specifically infect bacteria, resulting in their destruction. Bacterial infections are a common complication of wound healing, and experimental evidence from animal models demonstrates promising potential for phage-dependent eradication of wound-associated infections. The studies discussed suggest that phage therapy may be an effective treatment, with important advantages over some current antibacterial treatments. Phage cocktails, as well as co-administration of phages and antibiotics, have been reported to minimise bacterial resistance. Further, phage-antibiotic synergism has been reported in some studies. The ideal dose of phages is still subject to debate, with evidence for both high and low doses to yield therapeutic effects. Novel delivery methods, such as hydrogels, are being explored for their advantages in topical wound healing. There are more and more Good Manufacturing Practice facilities dedicated to manufacturing phage products and phage therapy units across the world, showing the changing perception of phages which is occurring. However, further research is needed to secure the place of phages in modern medicine, with some scientists calling upon the World Health Organisation to help promote phage therapy.
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Feleshtynskyi, Ya P. "Complications of ventral hernia alloplasty: treatment and prevention." Infusion & Chemotherapy, no. 3.2 (December 15, 2020): 292–93. http://dx.doi.org/10.32902/2663-0338-2020-3.2-292-293.
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Background. Postoperative ventral hernias (PVH) account for 22.4-25.0 % of the total number of abdominal hernias. Complications of PVH alloplasty are divided into general (abdominal compartment syndrome (ACS), acute intestinal obstruction, pneumonia, pulmonary embolism) and local (seroma, hematoma, suppuration, marginal skin defect, calcification, fistula).
Objective. To describe the treatment and prevention of complications of PVH alloplasty.
Materials and methods. Analysis of literature data on this topic.
Results and discussion. ACS occurs after alloplasty of giant PVG as a result of a steady increase in intra-abdominal pressure (IAP) >12 mm Hg within 6-12 hours after surgery. ACS is caused by the excessive tension of the supporting structures of the abdominal wall and a decrease in the volume of the abdominal cavity. The growth of IAP leads to compression of large vessels, kidneys, increased intrathoracic pressure with the development of heart and lung failure, so during and after surgery it is necessary to monitor this parameter with the help of Foley catheter. Prevention of ACS is carried out by the optimal choice of the method of compartment separation. In the postoperative period, anesthesia (paracetamol – Infulgan, “Yuria-Pharm”), oxygen therapy, abdominal bandaging, nonsteroidal anti-inflammatory drugs (NSAID), medications for the correction of water-electrolyte metabolism (Reosorbilact, “Yuria-Pharm”) are prescribed. Among wound complications seroma is the most common (30.8-60.4 %). Methods of its treatment include vacuum drainage, puncture, antibiotics and NSAID. In presence of localized limited infection in the tissues of the abdominal wall around the mesh, excision of the mesh area with granulomas within healthy tissues, washing of the wound with Dekasan solution (“Yuria-Pharm”) and defect plastics are indicated. Antibiotic therapy is performed according to sensitivity. In the presence of a widespread infection in the tissues of the abdominal wall along the perimeter of the mesh, its explantation is indicated. Repeated direct alloplasty in such cases is contraindicated. Prevention of wound complications includes antibiotic prophylaxis (ceftriaxone 2 g), adequate choice of alloplasty, washing of the surgical wound with Dekasan solution at the different stages of surgery, vacuum drainage and ultrasound monitoring.
Conclusions. 1. Optimization of prevention of wound complications during non-purulent surgical interventions is reached by washing of the surgical wound with Dekasan solution. 2. Optimization of prevention of wound complications during conditionally clean (non-purulent) surgical interventions is reached by antibiotic prophylaxis and washing of the surgical wound with Dekasan solution at various stages of surgical dissection.
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Kuo, David, Guanping Yu, Wyatt Hoch, Dean Gabay, Lisa Long, Mahmoud Ghannoum, Nancy Nagy, Clifford V. Harding, Rajesh Viswanathan, and Menachem Shoham. "Novel Quorum-Quenching Agents Promote Methicillin-Resistant Staphylococcus aureus (MRSA) Wound Healing and Sensitize MRSA to β-Lactam Antibiotics." Antimicrobial Agents and Chemotherapy 59, no. 3 (December 22, 2014): 1512–18. http://dx.doi.org/10.1128/aac.04767-14.
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ABSTRACTThe dwindling repertoire of antibiotics to treat methicillin-resistantStaphylococcus aureus(MRSA) calls for novel treatment options. Quorum-quenching agents offer an alternative or an adjuvant to antibiotic therapy. Three biaryl hydroxyketone compounds discovered previously (F1, F12, and F19; G. Yu, D. Kuo, M. Shoham, and R. Viswanathan, ACS Comb Sci 16:85–91, 2014) were tested for efficacy in MRSA-infected animal models. Topical therapy of compounds F1 and F12 in a MRSA murine wound infection model promotes wound healing compared to the untreated control. Compounds F1, F12, and F19 afford significant survival benefits in a MRSA insect larva model. Combination therapy of these quorum-quenching agents with cephalothin or nafcillin, antibiotics to which MRSA is resistant in monotherapy, revealed additional survival benefits. The quorum-quenching agents sensitize MRSA to the antibiotic by a synergistic mode of action that also is observedin vitro. An adjuvant of 1 μg/ml F1, F12, or F19 reduces the MIC of nafcillin and cephalothin about 50-fold to values comparable to those for vancomycin, the antibiotic often prescribed for MRSA infections. These findings suggest that it is possible to resurrect obsolete antibiotic therapies in combination with these novel quorum-quenching agents.
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Bektemirova, R. M., S. D. Khimich, V. N. Kondratyuk, A. V. Kryzhanovskaya, and O. O. Fomin. "The estimation of the treatment effectiveness of the experimental soft tissues septic wound with the application of polymer antimicrobial compound in the depo-form of decametoxinum." Reports of Vinnytsia National Medical University 22, no. 2 (December 5, 2018): 318–23. http://dx.doi.org/10.31393/reports-vnmedical-2018-22(2)-17.
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Today septic wound treatment demands from a surgeon a multipurpose approach. For the reason of the microorganisms’ resistance to antibiotics, specialists have to use more often various dosage forms of antiseptics. According to the topical cement antibiotic form, which is used in traumatology and orthopedics, the new antimicrobial polymer compound was designed, that contains decametoxinum. Previous studies in vitro proved the sustained-release of the agent. The purpose of our experiment is to study the treatment effectiveness of the new polymer compound dosage form of the decametoxinum in comparison with other treatment methods of septic-necrotic processes of soft tissues. We estimated on laboratory animals the effectiveness of alternative treatment approaches of the septic wound management, which were caused by S.аureus and P.аeruginosa, in different groups, including those where the new antiseptics’ dosage form was used. Three groups of the septic experimental wounds were treated by the principles of monotherapy — with liquid solution of decametoxinum, depo-form of decametoxinum and with intramuscular (IM) injection of etiological antibiotic — amikacin. The animals in fourth group received multipurpose treatment — depo-form of the decametoxinum topically with amikacin IM. Fifth group — was the control one. Visual estimation, bacteriological investigations were held according to the stages of the wound healing process. Macroscopic assessment of the wounds showed the best treatment effect in groups with depo-form application, especially during the first stage of the healing process. Finally, it was revealed that in groups where different dosage forms of decametoxinum were used the effectiveness of decontamination process was almost the same. But the wounds’ redressing with depo-form of decametoxinum was carried out once in three – four days, in comparison with daily redressings of the wounds in the group where it’s liquid form was used. The sanitation effect was more vital against P.aeruginosa, then in relation to S.aureus. The best results were received in the multipurpose treatment group — the complete bactericidal effect against all microbe populations was achieved. That grants us an idea about possible potentiation of the system antibiotic by topical antiseptic.
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Fomin, O. O., V. P. Kovalchuk, N. S. Fomina, M. D. Zheliba, Oleksandr Dobrovanov, and Karol Kralinsky. "Treatment of purulent-inflammatory complications in a combat gunshot trauma." Modern medical technologies 41 part 3, no. 2 (April 6, 2019): 34–39. http://dx.doi.org/10.34287/mmt.2(41).2019.37.
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Purpose of the study. Justification of the effective treatment tactics of the wounded with the gunshot fractures of the long bones.Materials and methods. The examination and treatment of 123 wounded with gunshot fractures were performed. All wounded were divided into 3 groups according to clinical observation. For the first clinical group the traditional treatment of the combat fractures with osteometallosynthesis out of injury zone was done. In the second group, treatment was added with negative pressure therapy. In the third clinical group Wounded got a VAC-associated therapy with the proposed of counter-drainage of wounds with the flow-washing irrigation with antiseptic solutions Decasan + 3% hydrogen peroxide. A bacteriological study of the wounds` exudates was carried out, and the sensitivity of microorganisms to antibiotics was determined.Results. The assay of microbiological investigation of the wounds of patients, which got explosive and mine-explosive injuries, demonstrated a predominance gram-negative microflora in the wound microbiocenoses such as Acinetobacter spp. (53% of cases) and Pseudomonas spp. (15% of cases). Gram-positive cocci were isolated from 22,2% of cases. The analysis of the antibiotic sensitivity data of gram-negative non-fermentative rods showed a high level of resistance to most antibacterial. All strains of acinetobacteria and pseudomonads were susceptible to polymyxin B and colistin, but resistant to unprotected and protected aminopenicillins (amoxicillin/clavulanate, ampicillin/sulbactam). Acceleration of regenerative processes in the wound under the influence of VAC-therapy (formation of healthy granulations, disappearance of edema) in patients with negative pressure suppression (II HS, III HS) led to a reduction of hospitalization period, which took in average 7,8 ± 1,2 days, that was 5,2 ± 0,8 days less than in a control group. In the third group of wounded, a mixture of Decasan and 3% hydrogen peroxide in the proportion of 3 : 1 was used for rinsing of wounds. On the third day tissue edema decreased in 94,45% of the wounded in that observation group, while in the second clinical group it was observed in 88,89% of patients. The duration of the hydration phase in the wound process was reduced to 5,7 days. The period of complete healing of the wounds was shorter for 2,5 days. The period of indoor stay of the wounded of this group in the hospital decreased from 14,97 to 10,8 days.Conclusions. Prevalence of gram-negative microorganisms in a gunshot wound and their high degree of resistance to antibiotics should be noticed when one takes a decision about empirical antibiotic therapy in the wounded. Observed clinical results of the proposed negative pressure therapy with counter-drainage of wounds by setting of flow-washing irrigation with a mixture of antiseptics Decasan and 3% hydrogen peroxide allow recommending this scheme for treatment of wounded with gunshot fractures of long bones.Keywords: Gunshot wound, antiseptics VAC-therapy.
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Kadam, Shai, Shahane, and Kaushik. "Recent Advances in Non-Conventional Antimicrobial Approaches for Chronic Wound Biofilms: Have We Found the ‘Chink in the Armor’?" Biomedicines 7, no. 2 (April 30, 2019): 35. http://dx.doi.org/10.3390/biomedicines7020035.
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Chronic wounds are a major healthcare burden, with huge public health and economic impact. Microbial infections are the single most important cause of chronic, non-healing wounds. Chronic wound infections typically form biofilms, which are notoriously recalcitrant to conventional antibiotics. This prompts the need for alternative or adjunct ‘anti-biofilm’ approaches, notably those that account for the unique chronic wound biofilm microenvironment. In this review, we discuss the recent advances in non-conventional antimicrobial approaches for chronic wound biofilms, looking beyond standard antibiotic therapies. These non-conventional strategies are discussed under three groups. The first group focuses on treatment approaches that directly kill or inhibit microbes in chronic wound biofilms, using mechanisms or delivery strategies distinct from antibiotics. The second group discusses antimicrobial approaches that modify the biological, chemical or biophysical parameters in the chronic wound microenvironment, which in turn enables the disruption and removal of biofilms. Finally, therapeutic approaches that affect both, biofilm bacteria and microenvironment factors, are discussed. Understanding the advantages and limitations of these recent approaches, their stage of development and role in biofilm management, could lead to new treatment paradigms for chronic wound infections. Towards this end, we discuss the possibility that non-conventional antimicrobial therapeutics and targets could expose the ‘chink in the armor’ of chronic wound biofilms, thereby providing much-needed alternative or adjunct strategies for wound infection management.
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Qiao, Bianbian, Qian Pang, Peiqi Yuan, Yilun Luo, and Lie Ma. "Smart wound dressing for infection monitoring and NIR-triggered antibacterial treatment." Biomaterials Science 8, no. 6 (2020): 1649–57. http://dx.doi.org/10.1039/c9bm02060h.
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O’Neill, Liam, Zach Nelson, Nadir Ahmad, Alec H. Fisher, Ana Denton, Michael Renzi, Henry S. Fraimow, and Luke Stanisce. "Malignant Fungating Wounds of the Head and Neck: Management and Antibiotic Stewardship." OTO Open 6, no. 1 (January 2022): 2473974X2110733. http://dx.doi.org/10.1177/2473974x211073306.
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Objective Malignant fungating wounds (MFWs) are unfortunate and underreported manifestations of some advanced head and neck cancers. The management of MFWs is complex and challenging. MFWs are often mistaken for infectious processes/abscesses and treated indiscriminately with oral or intravenous antibiotics. Our aim is to promote awareness of MFWs and provide education on their management. We summarize their cost-effective and evidence-based therapies and highlight antibiotic stewardship with respect to their management. Data Sources A literature review was performed of PubMed, Cochrane Review, SCOPUS, Embase, and Google Scholar databases regarding topical and systemic treatments for MFWs. Review Methods Full-text articles were identified with the following terms: fungating, ulcerative, wound, tumor, malignancy, antibiotics, topical, dressings, radiotherapy, head, neck, scalp, face, lip, and ear. Treatment recommendations were extrapolated, categorically summarized, and retrospectively assigned with an evidence level based on the GRADE system (Grading of Recommendations, Assessment, Development, and Evaluation). Conclusions In the absence of systemic signs and symptoms of infections, MFWs should not be treated as conventional infections or abscesses, with prophylactic oral or intravenous antibiotics. Topical treatments such as ointments and wound dressings are the mainstay in terms of managing the unsightly appearance and fetid odor from these entities. Implications for Practice MFWs are most often not amenable to definitive/curative surgical or nonsurgical therapy, but consultation with a head and neck oncologic specialist will help to determine if the underlying malignancy requires surgery, radiation therapy, or palliative treatment.
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Aliakbar, Adil Hassan, Malath Azeez Alsaadi, and Abbas Abd Zaid Barrak. "Evaluation of the Surgical and Pharmacological Treatment of Diabetic Foot Infection: A Retrospective Study." Open Access Macedonian Journal of Medical Sciences 7, no. 9 (May 14, 2019): 1499–504. http://dx.doi.org/10.3889/oamjms.2019.298.
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BACKGROUND: Diabetic foot infection is a major cause of patient disabilities and lowers limb amputations, with high treatment costs and hospitalisation requirements.
AIM: Aim of this study was to evaluate surgical wound care plus antibiotic effects in the treatment of mild and moderate diabetic foot infections.
METHODS: This retrospective study involved 60 patients with diabetic foot infections with or without osteomyelitis. The patients were categorised as group 1 mild and group 2 moderate. Both groups were treated using local wound debridement and the systemic administration of antibiotics. Group 1 (16) patients were treated with two regimens of oral antibiotics in two regimens, A (amoxicillin/clavulanate + metronidazole) and B (clindamycin + metronidazole), for 10-14 days. Group 2 (42) patients were treated with oral plus intravenous antibiotics in two regimens, A (ampicillin + cloxacillin + metronidazole) and B (lincomycin + metronidazole), for 6 weeks. The patients followed-up with local wound care specialists for 3 months to evaluate the treatment outcomes (cure, improvement, or failure).
RESULTS: Group 1 had an 80% cure rate under regimen A and a 100% cure rate under regimen B. Group 2 regimen A patients had a 61.5% cure rate and 11.53% improved, while regimen B patients had a 68.75% cure rate and 12.5% improved. Failure in both regimens was 23.8% in 20 patients with osteomyelitis, while 35% were cured and 20% improved during the study period.
CONCLUSION: Local surgical wound care for 3 months with antibiotic regimens for 6 weeks resulted in good response and cure rates, with lower costs and fewer instances of hospitalisation. Intravenous lincomycin and oral metronidazole achieved higher cure responses for moderate diabetic foot infections.
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Schultz, Hayley B., Roshan B. Vasani, Amy M. Holmes, Michael S. Roberts, and Nicolas H. Voelcker. "Stimulus-Responsive Antibiotic Releasing Systems for the Treatment of Wound Infections." ACS Applied Bio Materials 2, no. 2 (January 7, 2019): 704–16. http://dx.doi.org/10.1021/acsabm.8b00577.
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Zhang, Meiling, Ziwei Jiang, Dongqing Li, Deming Jiang, Yelin Wu, Hongyan Ren, Hua Peng, and Yuping Lai. "Oral Antibiotic Treatment Induces Skin Microbiota Dysbiosis and Influences Wound Healing." Microbial Ecology 69, no. 2 (October 10, 2014): 415–21. http://dx.doi.org/10.1007/s00248-014-0504-4.
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Silva, Sofia Cicolo da, Vívian Fratti Penna Ríspoli, Cesar Graner, Lilian Rose Marques de Sá, Carla Bargi Belli, and André Luís Do Valle De Zoppa. "Using tilapia skin (Oreochromis niloticus) as an occlusive biological curative in equine wounds:." Brazilian Journal of Veterinary Research and Animal Science 56, no. 4 (January 16, 2020): e154079. http://dx.doi.org/10.11606/issn.1678-4456.bjvras.2019.154079.
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Tilapia skin is being already use in humans and wild animals present burning wounds and showed a great result. The objective is to evaluate if tilapia skin used as an occlusive curative improves equine wound healing in two horses present chronic wound. Both animals are males, adults, both of breed Mangalarga Marchador South America. Every seven days wound we measured, photographed, biopsied for histopathological analysis, cleaned and tilapia curative was changed. Image J software was used to measure wound area. Tilapia skin as an occlusive biological factor seemed to improve healing process, wounds present an area reduction and clinical improvement during 35 days treatment, even though is still waiting for complete wound healing. In equine tilapia skin curative seemed to speed up healing process and allowed reduced curative change from every two days to once a week. This implies in decrease animal´s stress, less pain and treatment cost reduction since we used less bandage amount. Beside that tilapia skin industrial waste. Furthermore, it allowed avoid using antibiotics, which reduces environment pollution and there´s no antibiotic resistance issues.
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Ofstead, Cori L., Brandy L. Buro, Krystina M. Hopkins, and John E. Eiland. "The impact of continuous electrical microcurrent on acute and hard-to-heal wounds: a systematic review." Journal of Wound Care 29, Sup7 (July 1, 2020): S6—S15. http://dx.doi.org/10.12968/jowc.2020.29.sup7.s6.
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Background: Wound infections result in considerable morbidity, mortality and healthcare costs. Antibiotic resistance has complicated wound healing, and new, non-antibiotic-based treatment methods are being developed. Aims: To evaluate evidence on the safety, efficacy and real-world effectiveness of electroceutical devices (ECDs) that provide continuous electrical stimulation to wounds. Method: A systematic search was conducted to identify primary studies published between 2009 and 2019 that described therapeutic wound treatment using portable ECDs. Studies were included if the ECD delivered continuous electrical current directly to the wound area for the duration of treatment. Results: Of 171 citations identified in the search, 13 articles met the inclusion criteria and were analysed. Nine studies evaluated dressings embedded with zinc and silver particles that generated electricity electrochemically, and four evaluated electrode-based units with external batteries. ECDs were effective in healing complex, hard-to-heal wounds that had not responded to other treatments. Four studies showed that ECDs led to complete closure of wounds without complications, and in some cases healed wounds faster than standard of care (SOC). One study found that ECDs resulted in higher ratings by both patients and surgeons than SOC for the progression of wound healing and scar appearance. Additionally, three studies found ECD treatment was less expensive than SOC, due to patients requiring fewer dressing changes or nurse visits. Conclusion: ECDs appeared to be a safe, effective and cost-effective method for treating severe, complex and challenging wounds, including hard-to-heal wounds, surgical incisions and skin graft donor sites.
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Burman, Linnéa, Maia Diaz, Margrét Brands Viktorsdóttir, Helen Sjövie, Pernilla Stenström, Martin Salö, and Einar Ólafur Arnbjörnsson. "Wound Infection after Laparoscopic-Assisted Gastrostomy in Infants." Surgery Journal 05, no. 03 (July 2019): e96-e102. http://dx.doi.org/10.1055/s-0039-1696731.
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Abstract Background Gastrostomy placement in children is one of the most frequently performed pediatric surgical procedures and laparoscopic-assisted gastrostomy (LAG) is the preferred technique. Wound infection after LAG has become a significant concern due to the emergence of antibiotic resistance. The aim of this study was to describe the frequency of wound infection after LAG in children younger than 2 years of age and to identify the associated risk factors and the bacterial species involved. Methods Information about wound infection, results from bacterial cultures, and type of antibiotic treatment used within 30 postoperative days after LAG were compiled for infants who underwent LAG from 2010 to 2017. A retrospective chart review was performed. Data was compiled from charts and from an electronic database containing prospectively collected data. A multivariate logistic analysis was used to explore potential risk factors. Preoperative antibiotic prophylaxis and postoperative local wound care were conducted according to standard procedures. Results The 141 included infants underwent surgery at a median age of 10 months (range: 1–24). Thirty-eight (27%) patients had a clinically determined wound infection, bacteria were cultured from 26/38 (69%), and 30/38 (79%) received antibiotic treatment. The median interval from surgery to detection of a clinical wound infection was 14 days (range: 4–30). The most common microbes discovered were skin bacteria Staphylococcus aureus or Streptococcus pyogenes, but respiratory and intestinal bacteria were also found. Multivariate logistic regression analysis revealed no independent risk factors for infection such as age, gender, or underlying diagnosis. Conclusion Infants have a high rate of postoperative clinical wound infection after LAG despite the use of preoperative antibiotic prophylaxis and intense local wound care. Gender, age at operation, and previous diagnoses were not found to be independent risk factors for wound infection.
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Jacobsen, F., C. Fisahn, M. Sorkin, I. Thiele, T. Hirsch, I. Stricker, T. Klaassen, A. Roemer, B. Fugmann, and L. Steinstraesser. "Efficacy of Topically Delivered Moxifloxacin against Wound Infection by Pseudomonas aeruginosa and Methicillin-Resistant Staphylococcus aureus." Antimicrobial Agents and Chemotherapy 55, no. 5 (February 22, 2011): 2325–34. http://dx.doi.org/10.1128/aac.01071-10.
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ABSTRACTWound infection is a common risk for patients with chronic nonhealing wounds, causing high morbidity and mortality. Currently, systemic antibiotic treatment is the therapy of choice, despite often leading to several side effects and the risk of an insufficient tissue penetration due to impaired blood supply. If systemically delivered, moxifloxacin penetrates well into inflammatory blister fluid, muscle, and subcutaneous adipose tissues and might therefore be a possible option for the topical treatment of skin and infected skin wounds. In this study, topical application of moxifloxacin was investigated in comparison to mupirocin, linezolid, and gentamicin using a porcine wound infection and a rat burn infection model. Both animal models were performed either by an inoculation with methicillin-resistantStaphylococcus aureus(MRSA) orPseudomonas aeruginosa. Wound fluid, tissue, and blood samples were taken, and bacterial counts as well as the moxifloxacin concentration were determined for a 14-day follow-up. A histological comparison of the rat burn wound tissues was performed. Both strains were susceptible to moxifloxacin and gentamicin, whereas mupirocin and linezolid were effective only against MRSA. All antibiotics showed efficient reduction of bacterial counts, and except with MRSA, infected burn wounds reached bacterial counts below 105CFU/g tissue. Additionally, moxifloxacin was observed to promote wound healing as determined by histologic analysis, while no induction of bacterial resistance was observed during the treatment period. The use of topical antibiotics for the treatment of infected wounds confers many benefits. Moxifloxacin is therefore an ideal candidate, due to its broad antibacterial spectrum, its high efficiency, and its potential to promote wound healing.
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Kovalenko, Olha, Oksana Osadcha, Anton Kovalenko, and Vitalii Nazarenko. "Treatment of widespread infected wounds of different etiology." Perioperaciina Medicina 2, no. 2 (November 1, 2019): 31–37. http://dx.doi.org/10.31636/prmd.v2i2.5.
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Background. The infections problem of the surgical departments is increasing due to resistance of pathogens to antibiotics, so it becomes an important issue to develop new regimens for the treatment of common infected wounds.
The aim of the study was expanding the possibility of treating infected wounds with the use of infusion therapy with reosorbylact, decasan antiseptic, and braxone and leflocin antibiotics.
Materials and Methods. 55 patients with infected wounds of different etiology were included in the study. The mean patients age was 43.4 ± 4.7 years. Decasan antiseptic used in the treatment of infected wounds in patients of the main group, the antibiotics braxon (tobramycin) and leflocin 750 (levofloxacinum) is intended simultaneously for empirical antibiotic therapy, reosorbylact solution is included in the infusion therapy.
Results. Intoxication syndrome was observed in patients with widespread infected wounds. The initial level of urea blood exceeded 1.6–1.7 times after the patient admission. Creatinine level decreased by 23 % from baseline for 5–7 days of treatment, in patients of the main group during infusion detoxication therapy with Reosorbylact, it remained raised to 9–11 days in patients of the comparison group. Leukocytosis, TGN, and LII decreased in case of empirical antibacterial therapy with braxone (tobramycin) and leflосin 750. The number of microbial associations decreased to 1.6 ± 0.3 using decasan for wound treatment up to 9 days. Bacterial contamination of wounds decreased to a level suitable for effective auto graft (<104 per 1 g of tissue).
Conclusions. The complex program of treatment for patients with infected wounds contributed to the reduction of intoxication syndrome, faster reduction of the number of microorganisms in the wound, preparation of wounds for skin graft, shortening the treatment time by 4.3 days.
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Marson, B. A., S. R. Deshmukh, D. J. C. Grindlay, B. J. Ollivere, and B. E. Scammell. "A systematic review of local antibiotic devices used to improve wound healing following the surgical management of foot infections in diabetics." Bone & Joint Journal 100-B, no. 11 (November 2018): 1409–15. http://dx.doi.org/10.1302/0301-620x.100b11.bjj-2018-0720.
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Aims Local antibiotics are used in the surgical management of foot infection in diabetic patients. This systematic review analyzes the available evidence of the use of local antibiotic delivery systems as an adjunct to surgery. Materials and Methods Databases were searched to identify eligible studies and 13 were identified for inclusion. Results Overall, the quality of the studies was poor. A single trial suggested that wound healing is quicker when a gentamicin-impregnated collagen sponge was implanted at time of surgery, with no difference in length of stay or rate of amputation. Results from studies with high risk of bias indicated no change in wound healing when a gentamicin-impregnated sponge was implanted during transmetatarsal amputation, but a reduction in the incidence of wound breakdown (8% vs 25%, not statistically significant) was identified. A significant cost reduction was identified when using an antimicrobial gel to deliver antibiotics and anti-biofilm agents (quorum-sensing inhibitors) compared with routine dressings and systemic antibiotics. Analyses of case series identified 485 patients who were treated using local antibiotic delivery devices. The rates of wound healing, re-operation, and mortality were comparable to those that have been previously reported for the routine management of these infections. Conclusion There is a lack of good-quality evidence to support the use of local antibiotic delivery devices in the treatment of foot infections in patients with diabetes. Cite this article: Bone Joint J 2018;100-B:1409–15.