Maillard JY, Kampf G, Cooper R, et al.
JAC-antimicrobial resistance. Date of publication 2021 Mar 25;volume 3(1):dlab027.
1. JAC Antimicrob Resist. 2021 Mar 25;3(1):dlab027. doi: 10.1093/jacamr/dlab027.
eCollection 2021 Mar.
Antimicrobial stewardship of antiseptics that are pertinent to wounds: the need
for a united approach.
Maillard JY(1), Kampf G(2), Cooper R(3).
Author information:
(1)School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Cardiff,
Wales, UK.
(2)Institute of Hygiene and Environmental Medicine, University of Greifswald,
Germany.
(3)School of Sport & Health Sciences, Cardiff Metropolitan University, Cardiff,
Wales, UK.
Long before the nature of infection was recognized, or the significance of
biofilms in delayed healing was understood, antimicrobial agents were being used
in wound care. In the last 70 years, antibiotics have provided an effective means
to control wound infection, but the continued emergence of antibiotic-resistant
strains and the documented antibiotic tolerance of biofilms has reduced their
effectiveness. A range of wound dressings containing an antimicrobial (antibiotic
or non-antibiotic compound) has been developed. Whereas standardized methods for
determining the efficacy of non-antibiotic antimicrobials in bacterial suspension
tests were developed in the early twentieth century, standardized ways of
evaluating the efficacy of antimicrobial dressings against microbial suspensions
and biofilms are not available. Resistance to non-antibiotic antimicrobials and
cross-resistance with antibiotics has been reported, but consensus on breakpoints
is absent and surveillance is impossible. Antimicrobial stewardship is therefore
in jeopardy. This review highlights these difficulties and in particular the
efficacy of current non-antibiotic antimicrobials used in dressings, their
efficacy, and the challenges of translating in vitro efficacy data to the
efficacy of dressings in patients. This review calls for a unified approach to
developing standardized methods of evaluating antimicrobial dressings that will
provide an improved basis for practitioners to make informed choices in wound
care.
© The Author(s) 2021. Published by Oxford University Press on behalf of the
British Society for Antimicrobial Chemotherapy.
DOI: 10.1093/jacamr/dlab027
PMCID: PMC8209993
PMID: 34223101
