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Topical Antibiotics for Infected Wounds: A Review of the Clinical Effectiveness and Guidelines

Last updated: March 20, 2017
Project Number: RC0853-000
Product Line: Rapid Response
Research Type: Drug
Report Type: Summary with Critical Appraisal
Result type: Report


  1. What is the clinical effectiveness of topical antibiotics for patients with infected wounds?
  2. What are the evidence-based guidelines regarding the use of topical antibiotics for the treatment of infected wounds?

Key Message

One Cochrane systematic review was identified which examined the effectiveness of topical antibiotics for patients with infected wounds. Within the systematic review, one relevant study was identified which compared silver sulfadiazine to saline in 45 patients with infected pressure ulcers. The systematic review reported that there was no difference between groups with regards to infection eradication. Three sources were identified which provided evidence-based recommendations regarding the use of topical antibiotics for the treatment of infected wounds. Overall, limited and low quality evidence on the topic was identified to support these recommendations. While silver sulfadiazine was the only intervention of interest for which recommendations were provided in the included guidelines, there was a lack of consistency for its recommended use. The Japanese Dermatological Association stated that for deep chronic wounds with infection or necrotic tissue, sulfadiazine and silver have wide antimicrobial activity but are not suitable for wet wounds. The Wounds UK Best Practice Statement noted that silver sulfadiazine, in the form of cream and impregnated dressings, can be used for prophylaxis and treat¬ment of infection in second-and third degree burns, leg ulcers and pressure ulcers; but that it should not be used for longer than 2 weeks. In contrast, the Joanna Briggs Institute ‘Chronic Wound Management’ evidence summary notes that for infected or contaminated chronic wounds, there is insufficient evidence to recommend silver sulfadiazine.