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The use of topical antimicrobials is beneficial for infection control in wound care because wound infection is the major cause of delayed healing. The advantages of topical over systemic antimicrobials include a higher concentration at the target site, fewer systemic adverse effects, and a lower incidence of antimicrobial resistance. Nowadays, topical antimicrobials are divided into three groups: disinfectants, antiseptics, and antibiotics. Only antiseptics and antibiotics can be applied to living skin; therefore, this review will focus only on these groups. The advantages of each topical antimicrobial are well established; however, their disadvantages remain prominent. It is widely known that antiseptics show higher cytotoxicity and a broader spectrum of activity than antibiotics, whereas antibiotics show a higher probability of bacterial resistance development. However, there are still many adverse effects, resulting from each topical antimicrobial. This review aims to summarize the possible adverse effects of commonly used antiseptics (biguanide, silver, iodine, chlorine compounds, and other antiseptics), antibiotics (bacitracin, mafenide, mupirocin, neomycin, and silver sulfadiazine), and natural antimicrobials (curcumin and honey). Moreover, the antimicrobials that should be avoided in particular populations are also summarized in this review in order to increase awareness for antimicrobial selection in those populations. [ABSTRACT FROM AUTHOR]

There are many over-the-counter (OTC) bandage products available. In addition to their direct purchase by the public, many physicians provide OTC bandages to their patents after minor surgeries. The aim of this study was to evaluate in a well established porcine model the efficacy against Staphylococcus aureus of four OTC antimicrobial containing bandages as compared to two OTC ointments. Multiple partial thickness wounds were made on the backs of four pigs. The wounds were treated within 20 min after S. aureus inoculation. The wounds were cultured quantitatively at 24 and 48 h. Only one of the antibiotic bandages and one of the topical ointments were effective in reducing S. aureus proliferation in partial thickness wounds. The two treatments that were effective were the only treatments that contained neomycin. Although many OTC bandages and ointments contain antimicrobials, they may not be effective at reducing bacteria in wounds. [ABSTRACT FROM AUTHOR]

Pharyngeal perforations are uncommon in children and are usually secondary to instrumentation or external penetrating injuries. A delay in management can lead to life-threatening complications such as retropharyngeal abscess, mediastinitis, and airway compromise. We report three children who had pharyngeal perforation due to apparently innocuous injury and who developed serious complications. A high index of suspicion for a significant pharyngeal injury, use of lateral soft-tissue x-ray films of the neck, and flexible endoscopy in the emergency room can assist in early diagnosis when evaluating patients with oropharyngeal and penetrating neck injury. Prompt administration of broad-spectrum antibiotics, local drainage, and debridement can avert life-threatening complications. [ABSTRACT FROM AUTHOR]