The efficacy of topical gentamycin application on prophylaxis and treatment of wound infection: A systematic review and meta‐analysis

Abstract

Summary Objectives The purpose of this study was to conduct a systematic review and meta‐analysis in patients with local wound infection or infective risk, evaluating effects of topical gentamycin application on prophylaxis and treatment of wound infection. Methods Embase, the Cochrane Library, Pubmed, Medline (from Ovid) and three Chinese literature databases (CNKI, VIP and WANFANG) were searched. Randomised controlled studies (RCTs) and observational studies (OSs) that assessed the efficacy of topical gentamycin application on prophylaxis and treatment of local wound infection were included. The primary outcome was clinical efficacy. Secondary outcomes included duration of recovery time and length of hospital stay. Results Fifteen studies (1781 patients) met inclusion criteria. Twelve studies were RCTs and other three studies were OSs. Compared with non‐gentamycin group, topical gentamycin application had significantly higher rates of clinical efficacy (OR = 3.57, 95% CI 2.52‐5.07). In terms of duration of wound healing, it's taken shorter time in gentamycin group than non‐gentamycin group (OR = −4.94, 95% CI −8.37 to −1.51). However, the length of hospital stay had no significantly difference between the two groups (OR = −3.40, 95% CI −8.42 to 1.63). Subgroup analyses were conducted according to study design (RCTs or OSs), purpose and administration type. And the results showed that there were no significant difference of clinical efficacy in study design (P = 0.21, I2 = 35.4%), purpose (P = 0.32, I2 = 0%) and administration type subgroup (P = 0.74, I2 = 0%). However, topical gentamycin application had significantly shorter duration of wound healing in randomly controlled trials compared with observational studies, but had no difference in terms of administration type(P = 0.20, I2 = 38.6%). Conclusions Studies to date show that topical gentamycin application significantly increases the rate of clinical efficacy and decreases the duration of wound healing in patients with local wound infection or infective risk.

Precise spatial structure impacts antimicrobial susceptibility of S. aureus in polymicrobial wound infections

“…Previous studies have shown that P. aeruginosa -produced HQNO increases the tolerance of S. aureus to aminoglycosides in vitro ( 45 ); thus, we focused on this phenotype. We tested two different aminoglycosides: gentamicin, which has been used to successfully treat wound infections ( 49 , 50 ), and tobramycin, which is commonly used to treat chronic lung infections and more recently has been pursued as a prophylactic treatment to prevent wound infections ( 51 , 52 ). We first tested if S. aureus had altered tolerance in coinfected wounds and the role that HQNO plays in aminoglycoside tolerance.…”

Combining phages and antibiotic to enhance antibiofilm efficacy against an in vitro dual species wound biofilm

“…Gentamicin (GEN) is an aminoglycoside antibiotic that can be used for topical application to treat chronic wounds [ 12 ]. Recent clinical studies reveal that topical GEN application reduces the duration of wound healing [ 13 ], however, treatments should be limited in duration due to concerns about antibiotic resistance [ 14 ].…”

Delivery of topical gentamicin cream via platform wound device to reduce wound infection—A prospective, controlled, randomised, clinical study

“…The gentamicin sulfate cream was chosen as the topical antibiotic for this study because it is an FDA‐approved broad‐spectrum antibiotic that is commonly used to prevent and treat a wide variety of bacterial infections. A recent systematic review, meta‐analysis found that topical gentamicin cream application for wound infection prophylaxis and treatment significantly increased clinical efficacy and decreased the duration of wound healing 21 . In addition, we have previously demonstrated both in preclinical models as well as in clinical case studies that topical application of gentamicin with the PWD is efficient and safe 6 .…”

“…A recent systematic review, meta‐analysis found that topical gentamicin cream application for wound infection prophylaxis and treatment significantly increased clinical efficacy and decreased the duration of wound healing. 21 In addition, we have previously demonstrated both in preclinical models as well as in clinical case studies that topical application of gentamicin with the PWD is efficient and safe. 6 In a porcine study, ultrahigh concentrations (1000×MIC) of gentamicin delivered via PWD were used to treat P. aeruginosa ‐infected deep partial‐thickness burn wounds.…”