Silver in medicine: The basic science

Marx, David E.; Barillo, David J.

doi:10.1016/j.burns.2014.09.010

Cited by 128 publications

(123 citation statements)

References 86 publications

(159 reference statements)

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“…In lieu of classical antibiotics, a number of alternative antimicrobial treatments are being explored either individually (e.g., silver, 6 mannitol 7 ) or in combination with conventional antibiotics. 8–10 Unfortunately, high concentrations of these antimicrobials/antibiotics have toxic side effects 11,12 while at low concentrations they often decompose before completely eliminating biofilm communities.…”

Section: Introductionmentioning

confidence: 99%

Eradication of Pseudomonas aeruginosa biofilms and persister cells using an electrochemical scaffold and enhanced antibiotic susceptibility

Sultana

Call

Beyenal

2016

npj Biofilms Microbiomes

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Biofilms in chronic wounds are known to contain a persister subpopulation that exhibits enhanced multidrug tolerance and can quickly rebound after therapeutic treatment. The presence of these “persister cells” is partly responsible for the failure of antibiotic therapies and incomplete elimination of biofilms. Electrochemical methods combined with antibiotics have been suggested as an effective alternative for biofilm and persister cell elimination, yet the mechanism of action for improved antibiotic efficacy remains unclear. In this work, an electrochemical scaffold (e-scaffold) that electrochemically generates a constant concentration of H2O2 was investigated as a means of enhancing tobramycin susceptibility in pre-grown Pseudomonas aeruginosa PAO1 biofilms and attacking persister cells. Results showed that the e-scaffold enhanced tobramycin susceptibility in P. aeruginosa PAO1 biofilms, which reached a maximum susceptibility at 40 µg/ml tobramycin, with complete elimination (7.8-log reduction vs control biofilm cells, P ≤ 0.001). Moreover, the e-scaffold eradicated persister cells in biofilms, leaving no viable cells (5-log reduction vs control persister cells, P ≤ 0.001). It was observed that the e-scaffold induced the intracellular formation of hydroxyl free radicals and improved membrane permeability in e-scaffold treated biofilm cells, which possibly enhanced antibiotic susceptibility and eradicated persister cells. These results demonstrate a promising advantage of the e-scaffold in the treatment of persistent biofilm infections.

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Section: Introductionmentioning

confidence: 99%

Eradication of Pseudomonas aeruginosa biofilms and persister cells using an electrochemical scaffold and enhanced antibiotic susceptibility

Sultana

Call

Beyenal

2016

npj Biofilms Microbiomes

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“…As MCs and AnxA1 have been little explored in burns, the aim of this study was to analyze the profile of these cells by the assessment of their number and heterogeneity for tryptase and chymase, and also to evaluate the expression of AnxA1 in MCs and in skin flaps in a second degree burn model using the silver sulfadiazine at 1% (SDP 1%), considered the standard treatment for partial thickness burns due to its antimicrobial properties [36,37]. The results of these analyses may be useful for a better understanding of t he role of MCs and the protein AnxA1 in the wound healing process.…”

Section: Introductionmentioning

confidence: 99%

Heterogeneity of mast cells and expression of Annexin A1 protein in a second degree burn model with silver sulfadiazine treatment

et al. 2017

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Mast cells (MCs) participate in all stages of skin healing and one of their mediators is the Annexin A1 protein (AnxA1), linked to inflammation, proliferation, migration and apoptosis processes, but not studied in thermal burns yet. Therefore, our objectives were to evaluate the behavior of MCs and AnxA1 in a second degree burn model, treated or not with silver sulfadiazine 1% (SDP 1%) and associated to macrophages quantification and cytokines dosages. MCs counts showed few cells in the early stages of repair but increased MCs in the final phases in the untreated group. The normal skin presented numerous tryptase-positive MCs that were reduced after burning in all analyzed periods. Differently, few chymase-positive MCs were observed in the early stages of healing, however, increased chymase-positive MCs were found at the final phase in the untreated group. MCs also showed high immunoreactivity for AnxA1 on day 3 in both groups. In the tissue there was a strong protein expression in the early stages of healing, but in the final phases only in the SDP treated animals. TNF-α, IL-1β, IL-6, IL-10 and MCP-1 levels and macrophages quantification were increased in inflammation and reepithelialization phases. Reduced IL-1β, IL-6 and IL-10 levels and numerous macrophages occurred in the treated animals during tissue repair. Our results indicate modulation in the profile of MCs and AnxA1expression during healing by the treatment with SDP 1%, pointing them as targets for therapeutic interventions on skin burns.

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“…Most of the rest remains within the dressing or binds to proteins in the wound or wound debris [14,15].…”

Section: Safetymentioning

confidence: 99%

The Effectiveness and Safety of 1% Silver Sulfadiazine (Flammazine) Cream in Preventing Infection in Potentially Contaminated Traumatic Wounds among Pediatric Patients 2 To <18 Years Old: An Open-Label, Single-Arm Phase 3 Clinical Trial

Capeding¹,

Alberto²,

Guerrero³

2017

J Trauma Treat

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This is an open label, descriptive, single-arm study of patients, 2 to <18 years of age conducted at the out-patient department, Research Institute for Tropical Medicine (RITM), the primary objective of which is to evaluate the effectiveness and safety of silver sulfadiazine in preventing infection in potentially contaminated traumatic wounds among children 2 to <18 years of age.All of the 50 subjects enrolled had contaminated wound upon enrolment, without oral antibiotics and other topical medications previously used. After seven days of Flammazine application, 100% had clinical successand after 14 days of application, 100% of the subjects likewise had persistent clinical success. At baseline, the most common criteria present was pain (96%) followed by erythema (94%). 58% had mild itching, and 56% had mild tissue edema. Overall, the SIRS (Severity of Infection Rating Scale) scores improved after 7 days (100%) and 100% of the subjects had SIRS score of 0 after 14 days.The study has shown that 1% Silver Sulfadiazine appears to be an effective and safe alternative to antibiotics in the management of wound infections which are potentially contaminated among children 2 to <18 years of age.

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Silver in medicine: The basic science

Cited by 128 publications

References 86 publications

Eradication of Pseudomonas aeruginosa biofilms and persister cells using an electrochemical scaffold and enhanced antibiotic susceptibility

Eradication of Pseudomonas aeruginosa biofilms and persister cells using an electrochemical scaffold and enhanced antibiotic susceptibility

Heterogeneity of mast cells and expression of Annexin A1 protein in a second degree burn model with silver sulfadiazine treatment

The Effectiveness and Safety of 1% Silver Sulfadiazine (Flammazine) Cream in Preventing Infection in Potentially Contaminated Traumatic Wounds among Pediatric Patients 2 To <18 Years Old: An Open-Label, Single-Arm Phase 3 Clinical Trial

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