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Evaluation of short exposure times of antimicrobial wound solutions against microbial biofilms: from in vitro to in vivo.
- Source :
-
The Journal of antimicrobial chemotherapy [J Antimicrob Chemother] 2018 Feb 01; Vol. 73 (2), pp. 494-502. - Publication Year :
- 2018
-
Abstract
- Objectives: Test the performance of topical antimicrobial wound solutions against microbial biofilms using in vitro, ex vivo and in vivo model systems at clinically relevant exposure times.<br />Methods: Topical antimicrobial wound solutions were tested under three different conditions: (in vitro) 4% w/v Melaleuca oil, polyhexamethylene biguanide, chlorhexidine, povidone iodine and hypochlorous acid were tested at short duration exposure times for 15 min against 3 day mature biofilms of Staphylococcus aureus and Pseudomonas aeruginosa; (ex vivo) hypochlorous acid was tested in a porcine skin explant model with 12 cycles of 10 min exposure, over 24 h, against 3 day mature P. aeruginosa biofilms; and (in vivo) 4% w/v Melaleuca oil was applied for 15 min exposure, daily, for 7 days, in 10 patients with chronic non-healing diabetic foot ulcers complicated by biofilm.<br />Results: In vitro assessment demonstrated variable efficacy in reducing biofilms ranging from 0.5 log10 reductions to full eradication. Repeated instillation of hypochlorous acid in a porcine model achieved <1 log10 reduction (0.77 log10, P = 0.1). Application of 4% w/v Melaleuca oil in vivo resulted in no change to the total microbial load of diabetic foot ulcers complicated by biofilm (median log10 microbial load pre-treatment = 4.9 log10 versus 4.8 log10, P = 0.43).<br />Conclusions: Short durations of exposure to topical antimicrobial wound solutions commonly utilized by clinicians are ineffective against microbial biofilms, particularly when used in vivo. Wound solutions should not be used as a sole therapy and clinicians should consider multifaceted strategies that include sharp debridement as the gold standard.<br /> (© The Author 2017. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy.)
- Subjects :
- Administration, Topical
Animals
Disease Models, Animal
Pseudomonas aeruginosa drug effects
Staphylococcus aureus drug effects
Swine
Time Factors
Treatment Outcome
Anti-Infective Agents administration & dosage
Biofilms drug effects
Pseudomonas Infections drug therapy
Solutions administration & dosage
Staphylococcal Infections drug therapy
Wound Infection drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1460-2091
- Volume :
- 73
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- The Journal of antimicrobial chemotherapy
- Publication Type :
- Academic Journal
- Accession number :
- 29165561
- Full Text :
- https://doi.org/10.1093/jac/dkx391