Wound management in an era of increasing bacterial antibiotic resistance: A role for topical silver treatment

Background: Antibiotic-resistant bacteria represent an increasing concern in wound infections. Wound colonization with these organisms normally results in aggressive management of the wound complicated by a greatly limited choice of therapeutic antibiotics. Silver and other noble metals are recognized as potential allies in combating these organisms in wounds. Methods: Three types of topical silver applications were tested to determine their bactericidal efficacies against clinical isolates of antibiotic-resistant organisms. The silver-based applications represent 3 methods of applying silver to wounds: as a liquid (silver nitrate), incorporated in a cream (silver sulfadiazine) and as a dressing coating (silver-coated dressings). The reduction in the viable bacterial population recovered from test articles after exposure to silver provided a comparative measure of the bactericidal efficacies of these silver applications. Results: All of the products demonstrated an ability to reduce the number of viable bacteria. However, the methods varied in their efficacy against antibiotic-resistant bacteria, with the silver-coated dressing being the most efficacious and silver nitrate the least efficacious. Conclusions: Silver was demonstrated to be effective at killing the antibiotic-resistant strains tested. The silver-coated dressing was particularly rapid at killing the tested bacteria and was effective against a broader range of bacteria. Silver may be a useful prophylactic or therapeutic agent for the prevention of wound colonization by organisms that impede healing, including antibiotic-resistant bacteria.