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Update: Topical Antimicrobial Agents for Chronic Wounds

Sibbald, R. Gary MD, DSc (Hons), MEd, BSc, FRCPC (Med)(Derm), FAAD, MAPWCA; Elliott, James A.; Verma, Luvneed MAcc, BSc, MDc; Brandon, Alisa MSc, BSc; Persaud, Reneeka; Ayello, Elizabeth A. PhD, RN, ACNS-BC, CWON, ETN, MAPWCA, FAAN

doi: 10.1097/01.ASW.0000524471.28441.b9
Features: Clinical Management Extra

GENERAL PURPOSE: To provide information on the use of topical antimicrobial agents for the treatment of chronic wounds.

TARGET AUDIENCE: This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care.

LEARNING OBJECTIVES/OUTCOMES: After participating in this educational activity, the participant should be better able to:

1. Examine features of wounds and wound healing as well as the purpose of specific antimicrobial agents.

2. Identify potential therapeutic and adverse effects of specific topical antimicrobial agents for the treatment of chronic wounds.

ABSTRACT: Bacteria can delay or prevent healing in the surface compartment of a chronic wound or invade the deep and surrounding structures. This article focuses on the superficial compartment and the appropriate use of topical antimicrobial therapies. The authors have reviewed the published evidence for the last 5 years (2012–2017) and extrapolated findings to clinical practice with critical appraisal and synthesis of the recent literature with expert opinion, patient-centered concerns, and healthcare systems perspectives. Summary evidence tables for commonly used topical antimicrobials are included.

R. Gary Sibbald, MD, DSc (Hons), MEd, BSc, FRCPC (Med)(Derm), FAAD, MAPWCA • Professor • Medicine and Public Health • University of Toronto • Toronto, Ontario, Canada • Director • International Interprofessional Wound Care Course & Masters of Science in Community Health (Prevention & Wound Care) • Dalla Lana Faculty of Public Health • University of Toronto • Past President • World Union of Wound Healing Societies • Clinical Editor • Advances in Skin & Wound Care • Philadelphia, Pennsylvania

James A. Elliott • Faculty • International Interprofessional Wound Care Course • Member • Wounds Canada Research Committee • Trustee • T1 International • United Kingdom

Luvneed Verma, MAcc, BSc, MDc • Medical Student • University of Ottawa • Ottawa, Ontario, Canada

Alisa Brandon, MSc, BSc • Medical Student • University of Toronto • Toronto, Ontario, Canada

Reneeka Persaud • Faculty • International Interprofessional Wound Care Course • Research Coordinator • WoundPedia • Canada

Elizabeth A. Ayello, PhD, RN, ACNS-BC, CWON, ETN, MAPWCA, FAAN • Faculty • Excelsior College School of Nursing • Albany, New York • President • Ayello Harris & Associates, Inc • Copake, New York • Clinical Editor • Advances in Skin & Wound Care • Philadelphia, Pennsylvania

The author, faculty, staff, and planners, including spouses/partners (if any), in any position to control the content of this CME activity have disclosed that they have no other financial relationships with, or financial interests in, any commercial companies pertaining to this educational activity.

To earn CME credit, you must read the CME article and complete the quiz online, answering at least 13 of the 18 questions correctly.

This continuing educational activity will expire for physicians on October 31, 2018 and for nurses on October 31, 2019.

All tests are now online only; take the test at http://cme.lww.com for physicians and www.nursingcenter.com for nurses. Complete CE/CME information is on the last page of this article.

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