DOCSLIB.ORG

Use of Systemic Antibiotics and Antiseptics for Venous Leg Ulcers 5 Key in This Article

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Use of Systemic Antibiotics and Antiseptics for Venous Leg Ulcers 5 Key in This Article Nursing Practice ● The Cochrane Nursing Care Field writes Exclusive Cochrane summary exclusively for Nursing Wound care Times readers The presence of leg-ulcer infection may delay healing. A Cochrane review has found no evidence to support the routine use of systemic antibiotics as agents to promote the healing of venous leg ulcers Use of systemic antibiotics and antiseptics for venous leg ulcers 5 key In this article... points Evidence on systemic antibiotics for wound infection Venous leg Comparison between topical preparations 1ulcers affect The limitations of current evidence up to 1% of adults in developed countries Author Marinha Sofia Macedo is clinical reported. Five RCTs reported eight com- Leg ulcers can instructor for nursing research, nursing parisons of systemic antibiotics and the 2take years to development and Saudization, Nursing remaining studies compared topical prep- heal and are Research Division, King Faisal Specialist arations: cadexomer iodine, povidone- associated with Hospital and Research Centre, Riyadh, iodine, peroxide-based preparations, significant costs Saudi Arabia, and member of the honey-based preparations, silver-based Main strategies Cochrane Nursing Care Field (CNCF). preparations, topical antibiotics and other 3for leg-ulcer Abstract Macedo MS (2014) Use of systemic topical antiseptics. treatment are antibiotics and antiseptics for venous leg Participants could be treated in any compression ulcers. Nursing Times; 110: 25, 16-17. care setting and were those presenting with therapy, dressings A Cochrane review has brought together venous leg ulcers, as defined by the study and antimicrobial the available evidence on the use of author, or various wounds if the venous- therapy systemic antibiotics and topical antibiotics ulcer results were reported distinctly. The Antibiotics and antiseptics for infected leg ulcers. This intervention arm included antibiotics (top- 4should not be article presents a summary of the evidence ical or systemic, oral or intravenous) and used when wounds and describes its limitations. topical antiseptics. No specifications on are colonised but strength or duration were noted. The com- not infected enous leg ulcers are a type of parison arm was either a placebo, an alter- More research chronic wound that affects up to native antibiotic or antiseptic, any other 5is needed into 1% of adults in developed coun- therapy, usual care or no treatment. the effectiveness Vtries during their lives. These The primary outcome was wound of treatments for wounds can be slow to heal – from a few healing, which could be measured as time wound infection weeks to more than 10 years – and, in some to complete wound healing, proportion of cases, never do so. They are usually associ- wounds healed during follow-up, and ated with significant cost to patients and changes in wound size when compared healthcare systems. with size at baseline. Secondary outcomes The main strategies to treat venous were changes in signs and symptoms of ulcers are compression therapy, primary clinical infection, changes in bacterial flora, wound contact dressings and antimicrobial development of bacterial resistance, ulcer therapy when the wound is thought to be recurrence rates, adverse events, partici- infected. Two main approaches to manage pant satisfaction and health-related quality clinical infection in venous leg ulcers are: of life, and costs. » Systemic and topical antibiotics; Of the studies, three had low risk of bias » Antiseptics. (one on honey-based preparations and two A systematic review was undertaken to on silver-based preparations), 13 high risk of determine the effects of antibiotics and bias and 29 were at an unclear risk of bias. antiseptics on venous ulcers. Meta-analysis was done where possible. Review process Findings The review involved 45 randomised con- Systemic antibiotics trolled trials with a total of 4,486 partici- Five studies involving a total of 233 partici- Many treatments are used to treat infected Alamy pants, from which 53 comparisons were pants looked at systemic antibiotics. venous leg ulcers but not all are effective 16 Nursing Times 18.06.14 / Vol 110 No 25 / www.nursingtimes.net For a Nursing Times Learning unit on venous leg ulcer management, go to www.nursingtimes.net/ulcers They found the following: difference in healing between treatment was found between wounds treated with » Comparing co-trimaxazole, gentamicin groups in one trial comparing moist or chlorhexidine solution and usual care in or amikacin with standard care showed foam dressings with povidone-iodine. terms of time to healing. no significant difference in healing (one Two RCTs reported lower costs associated study); with povidone-iodine but a full economic Adverse events » Ciprofloxacin versus standard care or analysis was not presented for either trial. More participants reported adverse events placebo demonstrated no difference in for cadexomer iodine relative to standard complete healing at 3-4 months (two Peroxide-based preparations. Four trials (72 care. Severe irritations were associated studies); participants) tested peroxide-based prepa- with benzoyl peroxide; more frequent » Ciprofloxacin versus trimethoprim rations. Benzoyl peroxide 10% and 20% was adverse events were reported relative to showed no significant difference in significantly more effective than saline in honey-based preparations. healing (one study); terms of ulcer area remaining (one trial » Trimethoprim versus placebo showed each). Hydrogen peroxide 1% cream com- Conclusion no significant difference in healing pared with placebo resulted in significantly The studies did have some limitations: (one study); greater wound-area reduction (two trials). many were small and most were at high or » Amoxicillin versus topical povidone- unclear risk of bias. The review concludes: iodine showed no difference between Honey-based preparations. These were the » Evidence from RCTs of participants groups in complete healing (one study). subject of two multicentre RCTs with 476 with infected wounds is sparse; The limited data suggested recurrence participants. The first found no difference » It is difficult to interpret the effects of of ulcer infection was lower for in complete healing when the preparations antibiotics and antiseptics on healing povidone-iodine; were compared with hydrogels; the second and infection; » All ulcers treated with levamisole healed compared them with non-honey impreg- » No evidence is available to support the compared with 76% in the placebo nated dressings and found no difference in routine use of systemic antibiotics to group (one study). The review says this time to healing and change in health- promote healing venous leg ulcers; trial was small, so the effect could have related quality of life. » The lack of reliable evidence means it is occurred by chance. Three patients not possible to recommend the reported gastric adverse events. Silver-based preparations. A total of 12 RCTs discontinuation of any of the agents; with 1,514 participants, making 13 compari- » Levamisole was the only systemic Topical antibiotics and antiseptics sons, provided evidence on creams and antibiotic with evidence of benefit in Cadexomer iodine. The evidence on cadex- dressings containing silver. No differences terms of ulcer healing; omer iodine came from 11 RCTs with 922 were found between treatment groups » Some evidence supports the use of participants; seven trials compared it with when silver sulphadiazine cream was com- cadexomer iodine as a topical standard care. Data from four RCTs were pared with usual care (one trial), placebo preparation but it was linked to more pooled for the outcome of complete healing (one trial), non-adherent dressings (one adverse events than usual care; at 4-12 weeks, indicating 33% healed when trial) or growth factor (one trial). Compar- » Evidence does not support using given cadexomer iodine and 15% healed on ison between different silver-impregnated honey- or silver-based preparations; standard care. No differences in healing dressings found no difference between » The increase of bacterial resistance to were found when cadexomer iodine was groups (one trial); a further eight trials antibiotics means these are only compared with hydrocolloid dressings found no difference between silver-impreg- recommended in cases of clinical (one trial) paraffin gauze dressings (one nated and non-antimicrobial dressings. infection, not bacterial colonisation. NT trial), dextranomer (two trials) or silver- impregnated dressings (one trial). Other topical antibiotics and antiseptics. Five ● The full review is: O´Meara S et al (2014) RCTs (590 participants) provided evidence Antibiotics and antiseptics for venous leg Povidone-iodine. This was studied in six RCTs on other topical antibiotics and antiseptics. ulcers. Cochrane Database of Systematic (639 participants). When compared with For topical antibiotics, one RCT sug- Reviews. Issue 1. tinyurl.com/Cochrane- dextranomer in one trial, the mean time to gested an increase in the proportion healed wound-infection healing was shorter in the dextranomer at four weeks when patients were treated group (4.4 weeks versus 5.3 weeks) as was with enzymatic cleanser compared with time to eradication of Staphylococcus aureus chloramphenicol-containing ointment. RECOMMENDatIONS colonisation (14.7 days versus 18.7 days). No differences were found between groups However, this data should be interpreted in complete healing for: framycetin sul- ● Do not routinely use systemic
Load more

Recommended publications
  • Medication Code Key: PMCODE and Drug Name in 2007 NHHCS Cdc-Pdf
    Medication Code Key: PMCODE and Drug Name in 2007 NHHCS PMCODE Drug Name 00002 TAMIFLU 00003 DITROPAN XL II 00004 LIDODERM PATCH 00008 VIACTIV 00010 A AND D II 00013 MYCOPHENOLATE MOFETIL 00017 SIROLIMUS 00019 HAWTHORN 00027 SYNAGIS 00032 EXCEDRIN MIGRAINE 00036 MAALOX PLUS 00037 ACEON 00038 GLYSET 00039 SONATA 00042 PROTONIX 00044 PANLOR DC 00048 MOBIC 00052 SILDENAFIL CITRATE 00053 TAMSULOSIN HYDROCHLORIDE 00054 COMTAN 00058 MINERAL SUPPLEMENT 00061 BISMUTH 00071 CERTAVITE 00073 LUXIQ 00075 SAL-TROPINE 00076 TRILEPTAL 00078 AGGRENOX 00080 CARBIDOPA-LEVODOPA 00081 EXELON 00084 PREGABALIN 00085 ORAMORPH 00096 OSTEO-BIFLEX 00099 ALOCRIL 00100 A.S.A. 00101 ISOSORBIDE DINITRATE 00102 ISOSORBIDE MONONITRATE 00107 ROSIGLITAZONE MALEATE 00109 URSODIOL 00112 MEDERMA 00113 ANDROGEL 00114 DILTIA XT 00117 CRANBERRY 00123 NICOTINE 00125 AVELOX 00132 CAL-MAG 00133 CANDESARTAN Page 1 Medication Code Key: PMCODE and Drug Name in 2007 NHHCS PMCODE Drug Name 00148 PROLIXIN D 00149 D51/2 NS 00150 NICODERM CQ PATCH 00151 TUSSIN 00152 CEREZYME 00154 CHILDREN'S IBUPROFEN 00156 PROPOXACET-N 00159 KALETRA 00161 BISOPROLOL 00167 NOVOLIN N 00169 KETOROLAC TROMETHAMINE 00172 OPHTHALMIC OINTMENT 00173 ELA-MAX 00176 PREDNISOLONE ACETATE 00179 COLLOID SILVER 00184 KEPPRA 00187 OPHTHALMIC DROPS 00190 ABDEC 00191 HAPONAL 00192 SPECTRAVITE 00198 ENOXAPARIN SODIUM 00206 ACTONEL 00208 CELECOXIB 00209 GLUCOVANCE 00211 LEVALL 5.0 00213 PANTOPRAZOLE SODIUM 00217 TEMODAR 00218 CARBAMIDE PEROXIDE 00221 CHINESE HERBAL MEDS 00224 MILK AND MOLASSES ENEMA 00238 ZOLMITRIPTAN 00239
    [Show full text]
  • Advanced Textiles for Wound Care
    Woodhead Publishing in Textiles: Number 85 Advanced textiles for wound care Edited by S. Rajendran Oxford Cambridge New Delhi © 2009 Woodhead Publishing Limited The Textile Institute and Woodhead Publishing The Textile Institute is a unique organisation in textiles, clothing and footwear. Incorporated in England by a Royal Charter granted in 1925, the Institute has individual and corporate members in over 90 countries. The aim of the Institute is to facilitate learning, recognise achievement, reward excellence and disseminate information within the global textiles, clothing and footwear industries. Historically, The Textile Institute has published books of interest to its members and the textile industry. To maintain this policy, the Institute has entered into partnership with Woodhead Publishing Limited to ensure that Institute members and the textile industry continue to have access to high calibre titles on textile science and technology. Most Woodhead titles on textiles are now published in collaboration with The Textile Institute. Through this arrangement, the Institute provides an Editorial Board which advises Woodhead on appropriate titles for future publication and suggests possible editors and authors for these books. Each book published under this arrangement carries the Institute’s logo. Woodhead books published in collaboration with The Textile Institute are offered to Textile Institute members at a substantial discount. These books, together with those published by The Textile Institute that are still in print, are offered on the Woodhead web site at: www.woodheadpublishing.com. Textile Institute books still in print are also available directly from the Institute’s website at: www.textileinstitutebooks.com. A list of Woodhead books on textile science and technology, most of which have been published in collaboration with The Textile Institute, can be found at the end of the contents pages.
    [Show full text]
  • Debridement of Chronic Wounds: a Systematic Review
    Health Technology Assessment 1999; Vol. 3: No. 17 (Pt 1) Review The debridement of chronic wounds: a systematic review M Bradley N Cullum T Sheldon Health Technology Assessment NHS R&D HTA Programme HTA HTA How to obtain copies of this and other HTA Programme reports. An electronic version of this publication, in Adobe Acrobat format, is available for downloading free of charge for personal use from the HTA website (http://www.hta.ac.uk). A fully searchable CD-ROM is also available (see below). Printed copies of HTA monographs cost £20 each (post and packing free in the UK) to both public and private sector purchasers from our Despatch Agents. Non-UK purchasers will have to pay a small fee for post and packing. For European countries the cost is £2 per monograph and for the rest of the world £3 per monograph. You can order HTA monographs from our Despatch Agents: – fax (with credit card or official purchase order) – post (with credit card or official purchase order or cheque) – phone during office hours (credit card only). Additionally the HTA website allows you either to pay securely by credit card or to print out your order and then post or fax it. Contact details are as follows: HTA Despatch Email: [email protected] c/o Direct Mail Works Ltd Tel: 02392 492 000 4 Oakwood Business Centre Fax: 02392 478 555 Downley, HAVANT PO9 2NP, UK Fax from outside the UK: +44 2392 478 555 NHS libraries can subscribe free of charge. Public libraries can subscribe at a very reduced cost of £100 for each volume (normally comprising 30–40 titles).
    [Show full text]
  • Ehealth DSI [Ehdsi V2.2.2-OR] Ehealth DSI – Master Value Set
    MTC eHealth DSI [eHDSI v2.2.2-OR] eHealth DSI – Master Value Set Catalogue Responsible : eHDSI Solution Provider PublishDate : Wed Nov 08 16:16:10 CET 2017 © eHealth DSI eHDSI Solution Provider v2.2.2-OR Wed Nov 08 16:16:10 CET 2017 Page 1 of 490 MTC Table of Contents epSOSActiveIngredient 4 epSOSAdministrativeGender 148 epSOSAdverseEventType 149 epSOSAllergenNoDrugs 150 epSOSBloodGroup 155 epSOSBloodPressure 156 epSOSCodeNoMedication 157 epSOSCodeProb 158 epSOSConfidentiality 159 epSOSCountry 160 epSOSDisplayLabel 167 epSOSDocumentCode 170 epSOSDoseForm 171 epSOSHealthcareProfessionalRoles 184 epSOSIllnessesandDisorders 186 epSOSLanguage 448 epSOSMedicalDevices 458 epSOSNullFavor 461 epSOSPackage 462 © eHealth DSI eHDSI Solution Provider v2.2.2-OR Wed Nov 08 16:16:10 CET 2017 Page 2 of 490 MTC epSOSPersonalRelationship 464 epSOSPregnancyInformation 466 epSOSProcedures 467 epSOSReactionAllergy 470 epSOSResolutionOutcome 472 epSOSRoleClass 473 epSOSRouteofAdministration 474 epSOSSections 477 epSOSSeverity 478 epSOSSocialHistory 479 epSOSStatusCode 480 epSOSSubstitutionCode 481 epSOSTelecomAddress 482 epSOSTimingEvent 483 epSOSUnits 484 epSOSUnknownInformation 487 epSOSVaccine 488 © eHealth DSI eHDSI Solution Provider v2.2.2-OR Wed Nov 08 16:16:10 CET 2017 Page 3 of 490 MTC epSOSActiveIngredient epSOSActiveIngredient Value Set ID 1.3.6.1.4.1.12559.11.10.1.3.1.42.24 TRANSLATIONS Code System ID Code System Version Concept Code Description (FSN) 2.16.840.1.113883.6.73 2017-01 A ALIMENTARY TRACT AND METABOLISM 2.16.840.1.113883.6.73 2017-01
    [Show full text]
  • The Wound/Burn Guidelines –
    doi: 10.1111/1346-8138.13288 Journal of Dermatology 2016; : 1–22 GUIDELINE The wound/burn guidelines – 6: Guidelines for the management of burns Yuichiro YOSHINO,1 Mikio OHTSUKA,2 Masakazu KAWAGUCHI,3 Keisuke SAKAI,4 Akira HASHIMOTO,5 Masahiro HAYASHI,3 Naoki MADOKORO,6 Yoshihide ASANO,7 Masatoshi ABE,8 Takayuki ISHII,9 Taiki ISEI,10 Takaaki ITO,11 Yuji INOUE,12 Shinichi IMAFUKU,13 Ryokichi IRISAWA,14 Masaki OHTSUKA,15 Fumihide OGAWA,16 Takafumi KADONO,7 Tamihiro KAWAKAMI,17 Ryuichi KUKINO,18 Takeshi KONO,19 Masanari KODERA,20 Masakazu TAKAHARA,21 Miki TANIOKA,22 Takeshi NAKANISHI,23 Yasuhiro NAKAMURA,24 Minoru HASEGAWA,9 Manabu FUJIMOTO,9 Hiroshi FUJIWARA,25 Takeo MAEKAWA,26 Koma MATSUO,27 Osamu YAMASAKI,15 Andres LE PAVOUX,28 Takao TACHIBANA,29 Hironobu IHN,12 The Wound/Burn Guidelines Committee 1Department of Dermatology, Japanese Red Cross Kumamoto Hospital, Kumamoto, 2Department of Dermatology, Fukushima Medical University, Fukushima, 3Department of Dermatology, Yamagata University Faculty of Medicine, Yamagata, 4Intensive Care Unit, Kumamoto University Hospital, Kumamoto, 5Department of Dermatology, Tohoku University Graduate School of Medicine, Miyagi, 6Department of Dermatology, Mazda Hospital, Hiroshima, 7Department of Dermatology, Faculty of Medicine,University of Tokyo, Tokyo, 8Department of Dermatology, Gunma University Graduate School of Medicine, Gunma, 9Department of Dermatology, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Ishikawa, 10Department of Dermatology, Kansai
    [Show full text]
  • Table 1B 2005 Community Prescription Numbers, Together with Government
    TABLE 1B 2005 COMMUNITY PRESCRIPTION NUMBERS, TOGETHER WITH GOVERNMENT AND PATIENT COSTS FOR PBS-LISTED DRUGS Table 1B includes an estimate of community (non-public hospital) prescription numbers for the 2005 calendar year, costs (government and patient contribution) for the items with a four digit PBS/RPBS code, together with the defined daily dose (DDD) where assigned. There is no cost information available for items with a five digit Amfac drug code. Table 1 exclude the presentation of information on any item with an estimated community use of less than 110 prescriptions in 2005. The prescription items are arranged by ATC code on generic name, and by form and strength using either the PBS drug code (4 digit) or, for non-PBS items, the Amfac drug code (5 digit). Consult the index (page 255) by generic drug name to obtain the appropriate ATC code. An index by 2nd level of the ATC classification follows: ALIMENTARY TRACT AND METABOLISM PAGE NO A01 STOMATOLOGICAL PREPARATIONS 181 A02 DRUGS FOR ACID RELATED DISORDERS 182 A03 DRUGS FOR FUNCTIONAL GASTROINTESTINAL DISORDERS 185 A04 ANTIEMETICS AND ANTINAUSEANTS 187 A05 BILE AND LIVER THERAPY 188 A06 LAXATIVES 189 A07 ANTIDIARRHOEALS, INTESTINAL 191 ANTIINFLAMMATORY/ANTIINFECTIVE AGENTS A08 ANTIOBESITY PREPARATIONS, EXCLUDING DIET PRODUCTS 193 A09 DIGESTIVES, INCLUDING ENZYMES 194 A10 DRUGS USED IN DIABETES 195 A11 VITAMINS 197 A12 MINERAL SUPPLEMENTS 199 A14 ANABOLIC AGENTS FOR SYSTEMIC USE 200 177 BLOOD AND BLOOD FORMING ORGANS B01 ANTITHROMBOTIC AGENTS 201 B02 ANTIHAEMORRHAGICS 203 B03
    [Show full text]
  • Pharmacy Program and Drug Formulary
    Pharmacy Program and Drug Formulary Secure Horizons Group Retiree Medicare Advantage Plan n Pharmacy Program Description n Platinum Plus Enhanced Formulary California Benefits Effective January 1, 2006 Table of Contents Your Secure Horizons Group Retiree Medicare Advantage Plan Prescription Drug Benefit........................................................................................................ iii Secure Horizons Pharmacy Program Definitions .................................................................... iii What Is the Platinum Plus Enhanced Formulary? ....................................................................iv Where to Have Your Prescriptions Filled .................................................................................iv Preferred and Non-Preferred Network Pharmacies .................................................................iv Network Preferred Pharmacy Locations ..................................................................................iv How to Fill a Prescription at a Network Pharmacy ...................................................................v Mail Service Pharmacy ..............................................................................................................v Secure Horizons Group Retiree Medicare Advantage Plan Offers a Two-Part Prescription Drug Benefit ..........................................................................vii Part 1 – Medicare Part D Prescription Drug Coverage ...................................................vii How Your Medicare
    [Show full text]
  • Chronic Venous Ulcers: a Comparative Effectiveness Review of Treatment Modalities Comparative Effectiveness Review Number 127
    Comparative Effectiveness Review Number 127 Chronic Venous Ulcers: A Comparative Effectiveness Review of Treatment Modalities Comparative Effectiveness Review Number 127 Chronic Venous Ulcers: A Comparative Effectiveness Review of Treatment Modalities Prepared for: Agency for Healthcare Research and Quality U.S. Department of Health and Human Services 540 Gaither Road Rockville, MD 20850 www.ahrq.gov Contract No. 290-2007-10061-I Prepared by: Johns Hopkins University Evidence-based Practice Center Baltimore, MD Investigators Jonathan Zenilman, M.D. M. Frances Valle, D.N.P., M.S. Mahmoud B. Malas, M.D., M.H.S. Nisa Maruthur, M.D., M.H.S. Umair Qazi, M.P.H. Yong Suh, M.B.A., M.Sc. Lisa M. Wilson, Sc.M. Elisabeth B. Haberl, B.A. Eric B. Bass, M.D., M.P.H. Gerald Lazarus, M.D. AHRQ Publication No. 13(14)-EHC121-EF December 2013 Erratum January 2014 This report is based on research conducted by the Johns Hopkins University Evidence-based Practice Center (EPC) under contract to the Agency for Healthcare Research and Quality (AHRQ), Rockville, MD (Contract No. 290-2007-10061-I). The findings and conclusions in this document are those of the author(s), who are responsible for its contents; the findings and conclusions do not necessarily represent the views of AHRQ. Therefore, no statement in this report should be construed as an official position of AHRQ or of the U.S. Department of Health and Human Services. The information in this report is intended to help health care decisionmakers—patients and clinicians, health system leaders, and policymakers, among others—make well-informed decisions and thereby improve the quality of health care services.
    [Show full text]
  • The Effect of Iodine Based Products on Unicellular Algae from Genus Prototheca
    The Effect of Iodine Based Products on Unicellular Algae from Genus Prototheca University of Agricultural Sciences and Veterinary Medicine Cluj-Napoca, Faculty of Veterinary Medicine, 3-5Sorin Mănăştur RĂPUNTEAN Street, *, 400372, Gheorghe Romania RĂPUNTEAN, Flore CHIRILǍ, Nicodim Iosif FIŢ, George Cosmin NADǍŞ *Corresponding author: [email protected] Bulletin UASVM Veterinary Medicine 72(2) / 2015, Print ISSN 1843-5270; Electronic ISSN 1843-5378 DOI:10.15835/buasvmcn-vm: 11439 Abstract Iodine based products have been and are still used in medicine as disinfectant or antiseptic substances, because of their bactericidal, sporicidal, protocidal and disinfection effect. Algaecide effect has been lessPrototheca studied and represents a strong motivation for this study. This paper is aiming to test the sensitivityPrototheca to zopfii iodine based products of unicellular algae of the genus . Such products might be used for the treatment of diseases involving these pathogens. A total number of twenty-two strains isolated from cows with mastitis or bovine shelters, Protothecawere tested wickerhamii within this study. The algal strains were identified based on morphological characteristics (shape, size, presence of endospores), cultural (liquid and solid media characteristics) and biochemical (fermentation of sugars). ATCC 16529 reference strain was also included in the evaluation. Iodinated products used were represented by: Lugol solution, iodine tincture, betadine, videne and potassium iodide. Determination of the inhibitory effect was measured by diffusion technique in agarose gel and by liquid medium dilution method. For the tincture of iodine and betadine, the inhibitory effect was also appreciated in relation with the time of contact (5, 10, 15, 30 and 60 minutes). Prototheca zopfii By the agar diffusion technique, it was found that inhibition zones varying sizes were correlated with the composition of those products.
    [Show full text]
  • Table 1 2009 Community Prescription Numbers
    TABLE 1 2009 COMMUNITY PRESCRIPTION NUMBERS, TOGETHER WITH GOVERNMENT AND PATIENT COSTS FOR PBS LISTED DRUGS Table 1 includes an estimate of community prescription numbers for the 2009 calendar year, costs (government and patient contribution) for the items with a four digit PBS/RPBS code, together with the defined daily dose (DDD) where assigned. There is no cost information available for items with a five digit Amfac drug code. Table 1 excludes the presentation of information on any item with an estimated community use of less than 110 prescriptions in 2009. The prescription items are arranged by ATC code on generic name, and by form and strength using either the PBS drug code (4 digit plus alpha) or, for non-PBS items, the Amfac drug code (5 digit). Note that in this edition, “Item type” has been added to distinguish between PBS drug code and non-PBS drug code, for instance, P refers to PBS drug code and A refers to Amfac drug code. Note that Anatomical Therapeutic Chemical (ATC) classification index with Defined Daily Doses (DDDs) 2010 is used in all statistics published in this edition (refer to WHO collaborating Centre for Drug Statistics Methodology, ATC classification index with DDDs 2010). An index by second level of the ATC classification follows: ALIMENTARY TRACT AND METABOLISM 43 A01 STOMATOLOGICAL PREPARATIONS 43 A02 DRUGS FOR ACID RELATED DISORDERS 44 A03 DRUGS FOR FUNCTIONAL GASTROINTESTINAL DISORDERS 47 A04 ANTIEMETICS AND ANTINAUSEANTS 48 A05 BILE AND LIVER THERAPY 49 A06 LAXATIVES 51 A07 ANTIDIARRHOEALS, INTESTINAL ANTIINFLAMMATORY/ANTIINFECTIVES
    [Show full text]
  • A Comprehensive Review of Topical Odor-Controlling Treatment Options for Chronic Wounds
    Wound Care J Wound Ostomy Continence Nurs. 2016;43(6):598-609. Published by Lippincott Williams & Wilkins A Comprehensive Review of Topical Odor-Controlling 3 Treatment Options for Chronic Wounds Alma Akhmetova ¿ Timur Saliev ¿ Iain U. Allan ¿ Matthew J. Illsley ¿ Talgat Nurgozhin ¿ Sergey Mikhalovsky ABSTRACT The process of wound healing is often accompanied by bacterial infection or critical colonization, resulting in protracted infl ammation, delayed reepithelization, and production of pungent odors. The malodor produced by these wounds may lower health-related quality of life and produce psychological discomfort and social isolation. Current management focuses on reducing bacterial activity within the wound site and absorbing malodorous gases. For example, charcoal-based materials have been incorporated into dressing for direct adsorption of the responsible gases. In addition, multiple topical agents, including silver, iodine, honey, sugar, and essential oils, have been suggested for incorporation into dressings in an attempt to control the underlying bacterial infection. This review describes options for controlling malodor in chronic wounds, the benefi ts and drawbacks of each topical agent, and their mode of action. We also discuss the use of subjective odor evaluation techniques to assess the effi cacy of odor-controlling therapies. The perspectives of employing novel biomaterials and technologies for wound odor management are also presented. KEY WORDS: Chronic wound , Control , Dressing , Infection , Malodor , Odor , Therapy . INTRODUCTION evidence concerning the effi cacy of various interventions de- signed to reduce malodor produced by some chronic wounds Common clinical manifestations associated with wounds in- remains sparse. 5 clude pain, itch, odor, bleeding, and production of exudate; Unpleasant odor is often found in chronic wounds, and however, malodor is recognized as one of most distressful especially those that have not closed following 3 months of aspects of some wounds.
    [Show full text]
  • Antimicrobial Dressing for Diabetic Foot Ulcer Colonized with MRSA
    OnLine Journal of Biological Sciences Review Antimicrobial Dressing for Diabetic Foot Ulcer Colonized with MRSA Parthasarathy Ravichandran and Sai Prasad Chitti Department of Biochemistry and Molecular Biology, Pondicherry University, Pondicherry, India Article history Abstract: Wound healing in patients with diabetic foot ulcer differs Received: 24-05-2015 among people. The wound healing process was influenced by factors like Revised: 26-07-2015 nature of the wound, tissue and an immunity of a person. Any measure Accepted: 02-11-2015 taken to control bacterial colonies in wound plays a significant role in wound healing. However, recent emergence of Methicillin-resistant Corresponding Author: Parthasarathy Ravichandran Staphylococcus Aureus (MRSA) associated with chronic wounds created Department of Biochemistry health concerns worldwide. An MRSA colony present in diabetic wounds and Molecular Biology, vulnerable to prolong the wound healing has reported worldwide. Since Pondicherry University, MRSA are resistant to a wide range of antibiotics, choosing appropriate Pondicherry, India dressings to treat MRSA colonized wounds has become a challenge. Email: [email protected] Either synthetic or natural antimicrobial agents are used to develop dressings that combat against MRSA infections. In today’s practice, the incidence of chronic wounds and its associated socioeconomic consequences is rising despite effort and advances in wound management. In this review, an attempt made to summarize various antimicrobial dressings based on its activity against MRSA. Keywords: Wound, Honey, Silver, Antimicrobial, MRSA Introduction derivatives, including Methicillin are used for the treatments of infections caused by Staphylococcus The estimated prevalence of diabetes covers 382 aureus (Rayner and Munckhof, 2005). The misuse and million people (Tao et al ., 2015).
    [Show full text]