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 journalReviewpeer-review

  1. Socioeconomic functioning in patients with brain abscess - a nationwide, population-based cohort study in Denmark

    Research output: Contribution to journalJournal articlepeer-review

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

    Research output: Contribution to journalJournal articlepeer-review

  1. Prevalence of biofilms in acute infections challenges a longstanding paradigm

    Research output: Contribution to journalJournal articlepeer-review

  2. Nitric-oxide-driven oxygen release in anoxic Pseudomonas aeruginosa

    Research output: Contribution to journalJournal articlepeer-review

  3. Dynamics of skin microbiota in shoulder surgery infections

    Research output: Contribution to journalReviewpeer-review

  4. Biofilms can act as plasmid reserves in the absence of plasmid specific selection

    Research output: Contribution to journalJournal articlepeer-review

  5. The impact of mental models on the treatment and research of chronic infections due to biofilms

    Research output: Contribution to journalJournal articlepeer-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

Bibliographical note

Publisher Copyright:
© 2019

Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.

    Research areas

  • Biofilm, Chronic wound, Infection, Topical agent

ID: 59012082