Journal Article

Topical Antimicrobial Therapy for Treating Chronic Wounds

Benjamin A. Lipsky and Christopher Hoey

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 49, issue 10, pages 1541-1549
Published in print November 2009 | ISSN: 1058-4838
Published online November 2009 | e-ISSN: 1537-6591 | DOI:
Topical Antimicrobial Therapy for Treating Chronic Wounds

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Various agents have been applied topically to treat infected wounds for millennia, but their proper role remains unclear. Topical therapy affords many potential advantages but also has disadvantages. Opinions differ on which clinical signs define wound infection and on whether quantitative microbiological studies are useful. Clinically infected wounds usually require systemic antibiotic therapy, whereas clinically uninfected wounds that are healing as expected do not require antimicrobials. There is controversy over how to treat poorly healing wounds with “secondary” signs suggesting infection; these may benefit from topical antimicrobial agents. Some evidence supports using topical agents for malodorous or burn wounds. Meta-analyses and systematic reviews suggest there are few proven indications for topical antimicrobials. Use of a newer, relatively nontoxic antiseptic (eg, cadexomer iodine or silver dressings) is preferable to use of topical antibiotics, especially agents that are available for systemic use. We provide clinically relevant information on currently available topical antimicrobial agents.

Perhaps the most deceptively simple of all therapeutic procedures is the treatment of cutaneous infection with topical medication. Despite the unique accessibility of the skin to scientific investigation, it has for too long been the playground of crude empiricism. —Professor Sydney Selwyn, 1981[1]

Journal Article.  4523 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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