Currently, there is little information in the literature that helps guide the clinician to select which topical antibiotic would be most effective to reduce the high bacterial bioburden present in a particular chronic wound. The microbiology laboratory should provide topical antibiotic susceptibly testing to provide guidance on the most appropriate topical antibiotic. However, standard sensitivity tests are not appropriate for topical antibiotics. This study used the topical antimicrobial cream sensitivity test developed by Rodeheaver et al (1980) to evaluate the effectiveness of 10 topical antimicrobials against the bacteria that colonized 35 chronic wounds. No single product was effective for all 35 chronic wounds. The agent chosen to treat the wound was the one that produced the largest zone of bacterial inhibition. Silver sulfadiazine cream* produced the largest zone of bacterial inhibition in only 6 of 35 wounds. This study demonstrates one way that practitioners can partner with the laboratory to determine the most effective topical antibiotic for the specific chronic wound based on the results of the topical antimicrobial cream sensitivity test.

Product notation: *Silvadene®