Antibiotics and antiseptics for venous leg ulcers

O’Meara, Susan; Al‐Kurdi, Deyaa; Ovington, Liza G.

doi:10.1002/14651858.cd003557.pub2

Cited by 91 publications

(104 citation statements)

References 50 publications

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“…The authors concluded that few systemic agents improved outcomes, but several topical substances hastened healing, including silver-containing compounds for venous ulcers and oxyquinoline ointment for stage 1-2 pressure ulcers. A 2008 Cochrane systematic review of antibiotics and antiseptics for venous leg ulcers concluded that some evidence supports using topical cadexomer iodine, but further research is required to determine the effectiveness of povidone iodine, peroxide-based preparations, ethacridine lactate, and mupirocin for healing venous leg ulcerations [45]. Similarly, a 2008 systematic review of the effectiveness of various interventions for enhancing the healing of chronic diabetic foot ulcers found a single study that demonstrated no benefit of cadexomer-iodine in cavitary wounds and one suggesting that zinc oxide tape improved necrotic wounds more than a hydrocolloid [46].…”

Section: What Is the Evidence For Using Topical Antimicrobials For Trmentioning

confidence: 99%

Topical Antimicrobial Therapy for Treating Chronic Wounds

2009

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Various agents have been applied topically to treat infected wounds for millennia, but their proper role remains unclear. Topical therapy affords many potential advantages but also has disadvantages. Opinions differ on which clinical signs define wound infection and on whether quantitative microbiological studies are useful. Clinically infected wounds usually require systemic antibiotic therapy, whereas clinically uninfected wounds that are healing as expected do not require antimicrobials. There is controversy over how to treat poorly healing wounds with "secondary" signs suggesting infection; these may benefit from topical antimicrobial agents. Some evidence supports using topical agents for malodorous or burn wounds. Meta-analyses and systematic reviews suggest there are few proven indications for topical antimicrobials. Use of a newer, relatively nontoxic antiseptic (eg, cadexomer iodine or silver dressings) is preferable to use of topical antibiotics, especially agents that are available for systemic use. We provide clinically relevant information on currently available topical antimicrobial agents.

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Section: What Is the Evidence For Using Topical Antimicrobials For Trmentioning

confidence: 99%

Topical Antimicrobial Therapy for Treating Chronic Wounds

2009

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“…A 2008 Cochrane review suggested that additional research is needed to determine the effectiveness of antibiotic therapy in treating venous ulcers [22]. Currently, systemic antibiotic therapy is reserved for infected leg ulcers.…”

Section: Antibiotic Therapymentioning

confidence: 99%

Venous Leg Ulcerations: A Treatment Update

Farah

Davis

2010

Curr Treat Options Cardio Med

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Selecting the appropriate treatment for venous leg ulcerations is essential for optimal wound healing and patient quality of life. Compression therapy remains the mainstay of treatment for these wounds. Compression methods should be carefully selected and tailored for compatibility with patients' daily life. Pain management should not be neglected. When response to compression therapy is limited, adjuvant therapy such as medication, débridement, or surgical procedures should be considered on an individual basis.

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“…Ein weiterer sind die potenziellen systemischen Nebenwirkungen [6,9]. Der Einsatz systemischer Antibiotika bei Wundinfektionen bleibt folglich weiter umstritten [2,13,14].…”

Section: Vergleichende In-vitro-studie Zur Zytotoxizität Klinisch Einunclassified

“…[2] schlussfolgerten in einem kürzlich veröf-fentlichten Cochrane-Review, dass die Studienlage zu gering ist, um einen positiven Effekt von systemischen und topischen antibakteriellen Agenzien bei der Behandlung von S.-aureus-infizierten topischen Ekzemen auszumachen [2]. Eine weitere aktuelle Cochrane-Metaanalyse kommt zu einer ähnlichen Schlussfolgerung für die Behandlung chronisch venöser Ulzera: kein Hinweis auf einen positiven Effekt bei systemischen Antibiotika, eine zu geringe Datenlage, um eine valide Aussage bezüglich topischer Antiseptika zu treffen [13]. Auch bei präoperativ eingesetzten topischen Antiseptika konnte keine relevante Reduktion postoperativer Wundinfektionen gezeigt werden [17].…”

Section: Diskussionunclassified