RNAO BPG Pressure Ulcers Stage I to IV - Faculty of Health ...

Assessment & Management of Stage I to IV Pressure UlcersAppendix N: Topical Antimicrobial AgentsSource: Sibbald, Orsted et al. (2006). Reprinted with permission.Topical Antimicrobials Useful in Wounds with Overt and Covert Infection--S. AureusMRSAStreptococcusPseudomonasAnaerobesAgent Comments SummaryCadexomer IodineSilver++++++++++Also debrides. Low potential for resistance.Caution with thyroid disease.Do not use with saline. Low potential forresistance.Low riskand effectiveSilver Sulfadiazine+++++Caution with sulphonamide sensitivityPolymycin BSulphate/BacitracinZinc+++++Bacitracin in the ointment is an allergen;the cream formulation contains theless-sensitizing gramicidin.MupirocinMetrondiazole++Reserve for MRSA and other resistantGram+ speciesReserve for anaerobes and odour control.Low or no resistance of anaerobes despitesystemic use.Use selectivelyBenzoyl peroxideWeakWeakWeakWeakLarge wounds. Can cause irritation and allergy.GentamicinFusidin ointmentPolymyxin Bsulphate/Bacitracinzinc neomycin++++++++++Reserve for oral/IV use-topical use mayencourage resistance.Contains lanolin (except in the cream).Neomycin component causes allergies, andpossibly cross-sensitizes to aminoglycosides.Use with cautionWhere “+” indicates the infection(s) to which the agent is useful.98