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Crossover Study of Silver-Embedded White Coats in Clinical Practice

Everson, Nathan PharmD*; Chambers, Rachel M. PharmD, BCPS, AQ-ID; Tibbetts, Robert PhD; Davis, Susan L. PharmD†‡

Infectious Diseases in Clinical Practice: May 2014 - Volume 22 - Issue 3 - p 145–147
doi: 10.1097/IPC.0b013e31829a826b
Original Articles

Background Silver has antimicrobial properties and application in infection prevention. This study compared silver-embedded coats to polyester white coats during clinical practice.

Methods This study was a prospective randomized crossover with deception. Consenting medical residents were assigned to wear silver-embedded or control coats for 1 week and then crossed over. Bacterial cultures were obtained from 3 sites on the coat at baseline and 7 days. Bacterial growth (CFU/mL) was log transformed, and means were compared.

Results Seventeen participants were enrolled. Sixty-one percent of control and 45% of silver coats had bacterial growth at baseline (P = 0.113). After 7 days of wear, 98% versus 90% had growth (P = 0.205). At 7 days, a log reduction of −0.40 (0.09 to −0.71) (P = 0.011) for aggregate of all 3 sites was seen favoring silver coats. Two hundred seventy-seven bacterial isolates (124 silver, 153 control) were analyzed. Species distribution was similar between the coats.

Conclusions During routine clinical use, silver coats were associated with a modest reduction in bacterial contamination compared to control coats. Clinical correlation to transmission of nosocomial organisms warrants further study.

From the *Carilion Clinic, Roanoke, VA; †Henry Ford Hospital, Detroit, MI and ‡Wayne State University, Detroit, MI.

Correspondence to: Susan L. Davis, PharmD, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, 259 Mack Ave, Detroit, MI 48201. E-mail:

NE, RMC, and RT have no conflicts of interest to disclose relevant to this article. SLD has served as a paid consultant for Forest Inc, Premier Inc, Cubist, and Durata.

Noble Biomaterials supplied the control and silver coats for this study at no cost. No other financial support was provided. Noble Biomaterials was not involved in the study design, conduct, analysis of the data, or development of the manuscript.

At the time of completion of this study, N. Everson was affiliated with Henry Ford Hospital, Detroit, MI.

© 2014 by Lippincott Williams & Wilkins.