Irrigation with antibiotic-containing solutions for the prevention and treatment of infections

Abstract

Administration routes for antimicrobial agents used in clinical practice include the topical, inhaled, enteral and parenteral routes. An antibiotic administration route used frequently worldwide, although not well-studied, involves the irrigation of wounds with antibiotic-containing solutions for the prevention and treatment of infections. This review considers the data available from various experimental and clinical studies in order to provide an update on the use of antibiotic-containing solutions in modern clinical practice. Although irrigation with antibiotic-containing solutions has been suggested to be beneficial in the prevention or treatment of infections in several settings and patient populations, no firm, evidence-based recommendations can be made regarding its use until additional data from well-designed, randomised clinical trials become available. Current exceptions include empyema following lobectomy, or pneumonectomy and pyocystis (vesical empyema), since irrigation with solutions containing antimicrobial agents seems to be a crucial component of the management of these conditions.

Antibiotic-Releasing Mesh Coating to Reduce Prosthetic Sepsis: An In Vivo Study

“…Some surgeons use prophylactic antibiotic lavage of surgical sites. In general, this practice lacks strong supportive evidence in general surgery and other fields [3]. Others have turned towards the field of drug delivery polymers as a means of delivering locally administered drug.…”

Pyocystis and Prostate Abscess in a Hemodialysis Patient in the Emergency Department

“…The medical literature on hemodialysis patients with pyocystis contains only case reports and is unable to quantify the incidence and prevalence of this infectious complication 7–9,21,22. We were unable to find any reported cases of pyocystis associated with prostatic abscess in a hemodialysis-dependent patient.…”

“…Although oral antibiotics have been effective in treating symptomatic urinary tract infections in the hemodialysis-dependent population,18 the nature of pyocystis as an abscess formed within the bladder necessitates bladder drainage, parenteral antibiotics, and consideration of bladder irrigation with bactericidal solutions 8,9,12,21. Successful treatment has been reported with bladder irrigation solutions containing silver nitrate, chlorhexadine, acetic acid, or nitrofurantoin 12.…”

“…Successful treatment has been reported with bladder irrigation solutions containing silver nitrate, chlorhexadine, acetic acid, or nitrofurantoin 12. Further source control may be accomplished by transurethral cystoscopy, suprapubic cystostomy,21,23 Spence urethrovaginal fistula,7 or cystectomy. Cystectomy is avoided where possible, especially in hemodialysis patients in whom future kidney transplantation is considered a possibility.…”

Antibiotic-releasing microspheres prevent mesh infection in vivo

“…Additionally, pulse lavage with or without antibiotics lacks evidence to support its efficacy[4,5] and perioperative systemic antibiotics can produce serious side effects, especially with prolonged administration[6], limiting their use in long-term prophylaxis.…”