Synergistic Effects of Silver Carboxylate and Chlorhexidine Gluconate for Wound Care and Prevention of Surgical Site Infections by <i>Cutibacterium acnes</i> and Methicillin-Resistant <i>Staphylococcus aureus</i>

Garcia, Dioscaris; Vishwanath, Neel; Allu, Sai; Dockery, Dominique M; Berns, Ellis; Spake, Carole S.L.; Li, Troy; Barrett, Caitlin; Antoci, Valentin; Born, Christopher T.

doi:10.1089/sur.2021.237

Cited by 2 publications

(5 citation statements)

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“… 20 Sutures coated with AgCar:CHG showed sustained antimicrobial activity against MRSA and C. acnes , and were significantly more effective than Ethicon Triclosan-Coated VICRYL Plus Antibacterial sutures (the antimicrobial control) over a three- to four-day period. 20 These results suggest that the AgCar:CHG complex is a promising additional tool for prophylaxis of surgical site infections; however, more research must be conducted on its cytotoxicity to human cell lines. 31 …”

Section: Introductionmentioning

confidence: 91%

“… 19 – 23 Augmentation of penetration into areas where persister cells and biofilms thrive due to inaccessibility, such as pilosebaceous glands where pathogens like Cutibacterium acnes reside, would also enhance efficacy. 20 , 24 , 25 Lastly, as previously discussed, the ability of the antimicrobial agent to be effective against persister cells and biofilm formation, in addition to general antibiotic resistance, is key to addressing the growing problem.…”

Section: Introductionmentioning

confidence: 99%

“… 26 , 28 To address these concerns, silver carboxylate, a more novel formulation, has emerged as a likely safer and more efficacious alternative, especially as it potentially possesses several of the key novel antimicrobial traits mentioned previously. 20 , 22 , 23 , 29 – 32 Several studies on the formulation of silver matrices, antimicrobial activity, and cytotoxicity are currently being conducted to evaluate silver carboxylate as an effective clinical tool. 22 , 23 …”

Section: Introductionmentioning

confidence: 99%

“…Silver also has significant potential for the treatment of multidrug-resistant (MDR) pathogens. A proprietary formulation of silver carboxylate (AgCar) that has undergone extensive validation 20 , 22 , 23 , 30 has emerged as a promising antimicrobial silver formulation due to a matrix chemistry that allows for a controlled and predictable loading and release of silver carboxylate. 29 – 31 This modification has been reported to result in an increase in duration of action, a decrease in toxicity and is a potential solution to maintaining longer bactericidal activity with an improved safety profile.…”

Section: Introductionmentioning

confidence: 99%

“… 20 DRCs for C. acnes and MRSA were generated to determine the optimal therapeutic ratio of AgCar to CHG. 20 Coatings were applied to two different commercially available sutures, Ethicon Polyglactin-910 Coated VICRYL ® Plus (Somerville, NJ; termed Ethicon ® sutures), Arthrex FiberWire ® (uncoated braided polyethylene core structure; Naples, FL; termed FiberWire ® sutures), and Ethicon Triclosan Coated VICRYL Plus Antibacterial Sutures (termed Triclosan sutures), and antimicrobial efficacy was evaluated using Kirby-Bauer (KB) assays.20 GFAAS was used to measure AgCar elution from sutures over time. 20 Sutures coated with AgCar:CHG showed sustained antimicrobial activity against MRSA and C. acnes , and were significantly more effective than Ethicon Triclosan-Coated VICRYL Plus Antibacterial sutures (the antimicrobial control) over a three- to four-day period. 20 These results suggest that the AgCar:CHG complex is a promising additional tool for prophylaxis of surgical site infections; however, more research must be conducted on its cytotoxicity to human cell lines.…”

Section: Introductionmentioning

confidence: 99%

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Silver Carboxylate as an Antibiotic-Independent Antimicrobial: A Review of Current Formulations, in vitro Efficacy, and Clinical Relevance

Mette

Connolly

Vishwanath

et al. 2022

MRAJ

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The increasing prevalence of multi-drug resistant pathogens has led to a renewed focus on the use of silver as an antibiotic-independent antimicrobial. Unfortunately, the use of many silver formulations may be limited by an uncontrolled release of silver with the potential for significant cytotoxic effects. Silver carboxylate (AgCar) has emerged as an alternative formulation of silver with the potential to mitigate these concerns while still displaying significant bactericidal activity. This article reviews the efficacy of silver carboxylate formulations as a promising novel antibiotic-independent antimicrobial. This study was conducted through a search of five electronic databases (PubMed, Embase, MEDLINE, Cochrane Library, and Web of Science) for relevant studies up to September 2022. Searches were conducted for types of “silver carboxylate” formulations. Sources were compiled based on title and abstract and screened for inclusion based on relevance and study design. A review of the antimicrobial activity and cytotoxicity of silver carboxylate was compiled based on this search. Current body of data suggests that silver carboxylate shows promise as an emerging antibiotic-independent antimicrobial, with significant bactericidal effects while minimizing cytotoxicity. Silver carboxylate addresses several of the limitations of more primitive formulations, including controlled dosing and fewer negative effects on eukaryotic cell lines. These factors are concentration-dependent and largely rely on the vehicle system used to deliver it. Although several silver carboxylate-based formulations like titanium dioxide/ polydimethylsiloxane (TiO2/PDMS) matrix-eluting AgCar have shown promising results in vitro, and could potentially be utilized independently or in conjunction with current and future antimicrobial therapies, there is a need for further in vivo studies to validate their overall safety and efficacy profile.

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Section: Introductionmentioning

confidence: 91%