WASHINGTON—Minor, uncomplicated wounds – such as the typical cuts and scrapes of childhood – are less likely to become infected when kept clean and moist and treated with topical antibiotics, according to a literature review published online today in Annals of Emergency Medicine (“Do Topical Antibiotics Help Prevent Infection in Minor Traumatic Uncomplicated Soft Tissue Wounds?”) http://tinyurl.com/8ard5o2.
“The studies found significant differences between wounds that were simply kept moist and those that were kept moist with the application of a topical antibiotic,” said lead author Anna L. Waterbrook, MD, of the University of Arizona in Tucson. “In fact, wounds that were treated with topical creams that kept the wound moist but didn’t provide any antibiotic were associated with a higher infection rate and should not be used.”
Dr. Waterbrook and her team reviewed four studies in the medical literature.
The first found a range of infection rates between 4.5 percent and 12.1 percent among patients treated with various antibiotic treatments and an infection rate of 17.6 percent in patients treated only with petrolatum, which contained no antibiotic.
The second study found an infection rate of 4 percent in patients treated with mupirocin versus an infection rate of 0 percent in patients treated with a triple antibiotic ointment, which is less expensive and available over the counter.
The third study compared infection rates in children treated with either a novel antibiotic ointment (cetrimide, bacitracin and polymyxin B sulfate), a povidone iodine antiseptic cream or a placebo. The placebo group had an infection rate of 12.5 percent, the povidone iodine group had an infection rate of 3 percent and the novel antibiotic group had an infection rate of 1.6 percent.
The fourth study, also of children, compared a triple antibiotic ointment to a placebo ointment as a means to prevent streptococcal skin infections. Infections occurred in nearly half (47 percent) of the placebo group but in only 15 percent of the triple antibiotic group.
“The bottom line is that topical antibiotics may help prevent infection when used to treat minor wounds,” said Dr. Waterbrook. “It’s also important to clean the wound and keep it covered before applying an antibiotic cream. That’s good medicine for adults as well as children.”
Annals of Emergency Medicine is the peer-reviewed scientific journal for the American College of Emergency Physicians, the national medical society representing emergency medicine. ACEP is committed to advancing emergency care through continuing education, research, and public education. Headquartered in Dallas, Texas, ACEP has 53 chapters representing each state, as well as Puerto Rico and the District of Columbia. A Government Services Chapter represents emergency physicians employed by military branches and other government agencies. For more information visit www.acep.org.
December 9, 2013 //
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