Research
Print page Print page
Switch language
The Capital Region of Denmark - a part of Copenhagen University Hospital
Published

The efficacy of topical agents used in wounds for managing chronic biofilm infections: A systematic review

Research output: Contribution to journalJournal articleResearchpeer-review

  1. Complement related pattern recognition molecules as markers of short-term mortality in intensive care patients

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Incidence, presentation and outcome of toxoplasmosis in HIV infected in the combination antiretroviral therapy era

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Management of MDR-TB in HIV co-infected patients in eastern europe: results from the TB:HIV study

    Research output: Contribution to journalJournal articleResearchpeer-review

  4. Long-term mortality and causes of death associated with Staphylococcus aureus bacteremia. A matched cohort study

    Research output: Contribution to journalJournal articleResearchpeer-review

  1. Antibiotic susceptibility of cystic fibrosis lung microbiome members in a multispecies biofilm

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Bacterial aggregate size determines phagocytosis efficiency of polymorphonuclear leukocytes

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Early IL-2 treatment of mice with Pseudomonas aeruginosa pneumonia induced PMN-dominating response and reduced lung pathology

    Research output: Contribution to journalJournal articleResearchpeer-review

  4. Improving antibiotic treatment of bacterial biofilm by hyperbaric oxygen therapy: Not just hot air

    Research output: Contribution to journalReviewpeer-review

  5. The discovery of bacterial biofilm in patients with muscle invasive bladder cancer

    Research output: Contribution to journalJournal articleResearchpeer-review

  • S Schwarzer
  • G A James
  • D Goeres
  • T Bjarnsholt
  • K Vickery
  • S L Percival
  • P Stoodley
  • G Schultz
  • S O Jensen
  • M Malone
View graph of relations

OBJECTIVES: Clinicians have increasingly adopted the widespread use of topical agents to manage chronic wound infections, despite limited data on their effectiveness in vivo. This study sought to evaluate the evidence for commonly employed topical agents used in wounds for the purpose of treating chronic infections caused by biofilm.

METHOD: We included in vitro, animal and human in vivo studies where topical agents were tested for their efficacy against biofilms, for use in wound care. For human studies, we only included those which utilised appropriate identification techniques for visualising and confirming the presence of biofilms.

RESULT: A total of 640 articles were identified, with 43 included after meeting eligibility. In vitro testing accounted for 90% (n = 39) of all included studies, five studies using animal models and three human in vivo studies. Sixteen different laboratory models were utilised, with the most frequent being the minimum biofilm eradication concentration (MBEC™) / well plate assay (38%, n = 15 of 39). A total of 44 commercially available topical agents were grouped into twelve categories with the most commonly tested agents being silver, iodine and polyhexamethylene biguanide (PHMB). In vitro results on efficacy demonstrated iodine as having the highest mean log10 reductions of all agents (4.81, ±3.14).

CONCLUSION: There is large disparity in the translation of laboratory studies to researchers undertaking human trials relating to the effectiveness of commercially available topical agents. There is insufficient human in vivo evidence to definitively recommend any commercially available topical agent over another for the treatment of chronic wound biofilms. The heterogeneity identified between study designs (in vitro to in vivo) further limits the generalisability of results.

Original languageEnglish
JournalJournal of Infection
Volume80
Issue number3
Pages (from-to)261-270
Number of pages10
ISSN0163-4453
DOIs
Publication statusPublished - Mar 2020

    Research areas

  • Biofilm, Chronic wound, Infection, Topical agent

ID: 59012082