Silver serum levels in burned patients treated with silver sulfadiazine and its toxicity on inflammatory cells

Mimura, Erika Cristiane Mayumi; Favoreto, João Paulo Maximiano; Fávero, Maria Emília; Bonifácio, Kamila Landucci; Peixe, Tiago Severo; Morita, Andrea Akemi; Barbosa, Décio Sabbatini; Yabe, Maria Josefa Santos; Carrilho, A.J.F.

doi:10.1016/j.burns.2019.11.012

Cited by 18 publications

(15 citation statements)

References 30 publications

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“…It is well known that SSD has a broad antibiotic spectrum and rarely causes drug resistance. 16 , 27 , 28 The efficacy rate of SSD in our study is similar as previous ones, 29 , 30 therefore the comparable bacteria clearance rates between PL-5 spray and SSD cream demonstrated that PL-5 was as powerful as SSD in clearing bacteria at the wound site. Also, PL-5 successfully met the safety outcomes of this clinical trial by showing no SAE related to its application and having an incidence of AEs comparable to that of SSD.…”

Section: Discussionsupporting

confidence: 87%

Efficacy and Safety of PL-5 (Peceleganan) Spray for Wound Infections

Wei

Chen³

et al. 2022

Annals of Surgery

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Objective: To assess the safety and efficacy of antimicrobial peptide PL-5 (Peceleganan) spray in the treatment of wound infections. Background: Antimicrobial peptide PL-5 spray is a novel topical antimicrobial agent. Methods: We conducted a multicenter, open-label, randomized, controlled phase IIb clinical trial to evaluate the efficacy and safety of PL-5 spray, as compared with silver sulfadiazine, in patients with skin wound infections. The primary efficacy outcome was the clinical efficacy rate on the first day after ending the treatment (D8). The secondary efficacy outcome was the clinical efficacy rate on the fifth day posttreatment (D5), the bacteria clearance rate, and the overall efficacy rate at the mentioned 2 time points. The safety outcomes included adverse reactions and pharmacokinetic analysis posttreatment.Results: A total of 220 patients from 27 hospitals in China were randomly assigned to 4 groups. On D8, the efficacy rate was 100.0%, 96.7%, 96.7% for the 1‰ PL-5, 2‰ PL-5, 4‰ PL-5 groups, respectively, as compared with 87.5% for the control group. The efficacy rate among the 4 groups was significantly different (P < 0.05). On D5, the efficacy rate was 100.0%, 93.4%, 98.3% for the 1‰ PL-5, 2‰ PL-5, 4‰ PL-5 groups, respectively, as compared with 82.5% for the control group. The efficacy rate among the 4 groups was significantly different (P < 0.05). The blood concentration of PL-5 was not detectable in pharmacokinetic analysis. No severe adverse event related to the application of PL-5 was reported. Conclusions: Antimicrobial peptide PL-5 spray is safe and effective for the treatment of skin wound infections. Trial Registration: ChiCTR2000033334.

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Section: Discussionsupporting

confidence: 87%

Efficacy and Safety of PL-5 (Peceleganan) Spray for Wound Infections

Wei

Chen³

et al. 2022

Annals of Surgery

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“…SSD 1% has many benefits such as widespectrum antimicrobial properties, low cost, and high tolerability, and is commonly used by most in burn wounds 8 and some burn hospitals (such as our center), though it can delay the process of wound healing because of its negative effect on the regeneration of keratinocytes 9 . Other side effects of SSD include electrolyte imbalance, skin necrosis, skin discoloration, leukopenia, hyper-osmolality, methemoglobinemia, and hemolysis, liver and renal impairment 10 , slower epithelialization, higher cost, more infections, and more pain 1 .…”

Section: Introductionmentioning

confidence: 99%

The Comparison of Clinical and Histopathological Effects of Topical Psyllium (Plantago ovata) Powder and Silver Sul-fadiazine on Second-Degree Burn Wound Healing in Rats

Jalilimanesh

Azhdari

Mirjalili

et al. 2021

wjps

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BACKGROUND Burn wounds are a worldwide health problem, leading to physical and psychological disabilities in all age’s groups. With regard to absorbent properties of Plantago ovata mucilage which can decrease wound moisture, we aimed to compare the effect of silver sulfadiazine (SSD) 1% and powdered P. ovata on second-degree burn wound healing in rats. METHODS This experimental study was conducted on 30 male Wistar rats with second-degree burn in three groups. Group 1 (control) did not receive any treatment; group 2 and group 3 (treated groups) were dressed daily using SSD cream and P. ovata powder, respectively. The weight of rats, wound size (by applying ImageJ software) and percentage of wound healing on the 5 th , 7 th , 10 th , 13 th , 16 th , 19 th , and 22 nd days (by diagnosing a plastic surgeon) and histological cutaneous changes at day 22 were evaluated. The Prism software was applied for data analysis. The Haematoxylin & Eosin as well as Masson's trichrome staining were performed on wound skin biopsies. RESULTS On day 22 nd , 20%, 50% and 60% of the rats had complete wound healing in the control, SSD and P. ovat a groups, respectively. A significant decrease in wound size was shown in the treated groups compared to the control group ( P <0.01), but no significant difference was shown between the treated groups ( P >0.05). CONCLUSION However, the wound healing in P. ovata group or SSD was better than the control group, and the significant difference was not found with the treated group.

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“…Indeed, one day of exposure is sufficient to partially or totally inhibit a set of nuclear receptors under conditions very close to medical device exposure. [14][15][16] Besides, extremely low doses leading to less than 50 fg of silver per cell are sufficient to inhibit more than half of LXR activity, a key regulator of liver metabolism.…”

Section: Discussionmentioning

confidence: 99%

“…Besides, several studies in burn patients revealed Ag blood levels in the low to high micromolar range proving the relevance of Ag exposure in the medical context. [14][15][16] Therefore, it is of paramount importance to better understand the AgNP fate in the liver to predict the risk for patients during hospital care. In spite of its relevance, this exposure scenario has been as yet disregarded in nanotoxicology studies.…”

Section: Introductionmentioning

confidence: 99%