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

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Harvard

Schwarzer, S, James, GA, Goeres, D, Bjarnsholt, T, Vickery, K, Percival, SL, Stoodley, P, Schultz, G, Jensen, SO & Malone, M 2020, 'The efficacy of topical agents used in wounds for managing chronic biofilm infections: A systematic review' Journal of Infection, vol. 80, no. 3, pp. 261-270. https://doi.org/10.1016/j.jinf.2019.12.017

APA

CBE

Schwarzer S, James GA, Goeres D, Bjarnsholt T, Vickery K, Percival SL, Stoodley P, Schultz G, Jensen SO, Malone M. 2020. The efficacy of topical agents used in wounds for managing chronic biofilm infections: A systematic review. Journal of Infection. 80(3):261-270. https://doi.org/10.1016/j.jinf.2019.12.017

MLA

Vancouver

Author

Schwarzer, S ; James, G A ; Goeres, D ; Bjarnsholt, T ; Vickery, K ; Percival, S L ; Stoodley, P ; Schultz, G ; Jensen, S O ; Malone, M. / The efficacy of topical agents used in wounds for managing chronic biofilm infections : A systematic review. In: Journal of Infection. 2020 ; Vol. 80, No. 3. pp. 261-270.

Bibtex

@article{77836135f0d04c6f9374b75ef387e460,
title = "The efficacy of topical agents used in wounds for managing chronic biofilm infections: A systematic review",
abstract = "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.",
keywords = "Biofilm, Chronic wound, Infection, Topical agent",
author = "S Schwarzer and James, {G A} and D Goeres and T Bjarnsholt and K Vickery and Percival, {S L} and P Stoodley and G Schultz and Jensen, {S O} and M Malone",
note = "Copyright {\circledC} 2019. Published by Elsevier Ltd.",
year = "2020",
month = "3",
doi = "10.1016/j.jinf.2019.12.017",
language = "English",
volume = "80",
pages = "261--270",
journal = "Journal of Infection",
issn = "0163-4453",
publisher = "W.B./Saunders Co. Ltd",
number = "3",

}

RIS

TY - JOUR

T1 - The efficacy of topical agents used in wounds for managing chronic biofilm infections

T2 - A systematic review

AU - Schwarzer, S

AU - James, G A

AU - Goeres, D

AU - Bjarnsholt, T

AU - Vickery, K

AU - Percival, S L

AU - Stoodley, P

AU - Schultz, G

AU - Jensen, S O

AU - Malone, M

N1 - Copyright © 2019. Published by Elsevier Ltd.

PY - 2020/3

Y1 - 2020/3

N2 - 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.

AB - 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.

KW - Biofilm

KW - Chronic wound

KW - Infection

KW - Topical agent

U2 - 10.1016/j.jinf.2019.12.017

DO - 10.1016/j.jinf.2019.12.017

M3 - Journal article

VL - 80

SP - 261

EP - 270

JO - Journal of Infection

JF - Journal of Infection

SN - 0163-4453

IS - 3

ER -

ID: 59012082