Clinical considerations for topical wound antisepsis or systemic antibiotic therapy
The continuing increase of bacterial resistance against antibiotics has demanded to reserve their use for strict and few indications. Therefore, during the past 10 years, significant advances have been made in the field of wound antisepsis for the management of patients with chronic wounds.
Antiseptic agents differ from antibiotics in three perspectives: (i) antiseptics are used topically and cannot be given systemically, (ii) they have more than one mechanism of action, and (iii) their bacteriostatic/bactericidal activity occurs within a matter of seconds rather than minutes or hours. Application of topical antisepsis on wounds has demonstrated a reduction of bacterial burden and suppresses of biofilm formation without adversely impacting the process of wound healing.
Today, there is agreement that topical antiseptic agents are preferred over topical antibiotic agents because they are broader in their spectrum of activity, practically unaffected by antimicrobial resistance and less likely to cause allergic reactions.
However, little information is available when the benefit of systemic antibiotics may surpass the abilities of topical antiseptics. This presentation will elaborate on clinical considerations under which circumstances patients with chronic wounds will benefit from systemic antibiotic treatment.
Medical Director of the Hospital Neunkirchen, Austria
Ojan Assadian was born in Vienna, Austria. He received a medical degree from the University of Vienna in 1997 and the Diploma in Tropical Medicine and Hygiene from the London School of Hygiene and Tropical Medicine in 2000. Since 1999, he has been...