Sulfadiazine silver 1% cream

Abstract Background Diabetes mellitus is increasing in Africa, and diabetes-related amputations exacerbated by diabetic foot infection are also prevalent with Staphylococcus aureus and Pseudomonas aeruginosa two priority pathogens playing key roles. Understanding the local epidemiology and antimicrobial resistance profiles of these dominant pathogens is crucial for appropriate antibiotic therapy. Main body of abstract This systematic review and meta-analysis aim to contribute valuable insights that can guide the management of diabetic foot ulcer-related infections in Africa by comprehensively analyzing the available literature on the prevalence and antimicrobial resistance profiles of Staphylococcus aureus and Pseudomonas aeruginosa in infected diabetic foot ulcers across Africa. We conducted a continent-based literature search utilizing PubMed and Scopus databases on June 11th, 2023, to identify studies conducted in Africa among persons with diabetic foot ulcers that reported isolating bacteria from the foot ulcers. The main concepts related to this research, “diabetic foot ulcers”, “diabetic foot infections”, “bacteria” and “Africa” were expanded with their synonyms and combined using Boolean operators (AND, OR) to formulate the final search query. The selection and inclusion of studies followed the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA). Our review revealed that approximately 4124 bacteria have been isolated from diabetic foot ulcers across 13 African countries. Staphylococcus aureus is the dominant species with a random effect pooled prevalence of 19.9% (95%CI: [16.19–23.84%]; I 2 = 88.56% [82.26–92.62%]) followed by Pseudomonas aeruginosa with 11.8% (95%CI: [8.67–15.23%]; I 2 = 89.95% [84.67–93.41%]). Methicillin-resistant Staphylococcus aureus (MRSA) pooled 12.9% (95%CI: [3.99–25.89%]; I 2 = 95.47% [93.68–96.75%]). Multidrug-resistant S.aureus and P. aeruginosa pooled prevalence is 26.4% (95%CI: [17.84–36.06%]; I 2 = 71.16% [49.34–83.58%]) and 41.8% (95%CI: [27.38–56.91%]; I 2 = 78.48% [60.80–88.18%]), respectively. Short conclusion Staphylococcus aureus dominates diabetic foot ulcer (DFU) isolates in Africa contrary to the prevailing assertion about Pseudomonas aeruginosa . However, multidrug resistance among both species is high emphasizing the need for antimicrobial stewardship and utilization of other wound management protocols such as topical silver sulfadiazine (SSD) for the duo.

Abstract licence: CC BY

Burn wounds remain a prevalent problem in the developed and developing world. A multitude of remedies has been tested. This study evaluated the healing time of second- and third-degree burn wounds between silver sulfadiazine (SSD) and Aloe vera (AV). In July 2020, a systematic review of MEDLINE (Ovid) and PubMed (National Library of Medicine) was performed to identify studies that reported healing of second- and third-degree burns using either SSD or AV. Articles meeting the inclusion criteria were screened and carefully analyzed. Our goal was to report the healing time for these burns using SSD and AV. A total of eight studies published between 1988 and 2018 reporting healing of second- and third-degree burns using SSD and AV were included in this review. Six were cohort studies and two were randomized controlled trials. The studies included both animal and human subjects. The meta-analysis demonstrated that the mean time to wound healing favored AV (RR: -1.34, 95% CI: -1.8 to 0.9, p < 0.001). It would seem that time to healing benefitted those burns in which AV was utilized. In conclusion, increased consideration and emphasis should be placed on using AV to aid the healing of second- and third-degree burns.

Abstract licence: CC BY

The growing demand for personalized medicine requires innovation in drug manufacturing to combine versatility with automation. Here, three-dimensional (3D) printing was explored for the production of chitosan (CH)/alginate (ALG)-based hydrogels intended as active dressings for wound healing. ALG hydrogels were loaded with 0.75% w/v silver sulfadiazine (SSD), selected as a drug model commonly used for the therapeutic treatment of infected burn wounds, and four different 3D CH/ALG architectures were designed to modulate the release of this active compound. CH/ALG constructs were characterized by their water content, elasticity and porosity. ALG hydrogels (Young’s modulus 0.582 ± 0.019 Mpa) were statistically different in terms of elasticity compared to CH (Young’s modulus 0.365 ± 0.015 Mpa) but very similar in terms of swelling properties (water content in ALG: 93.18 ± 0.88% and in CH: 92.76 ± 1.17%). In vitro SSD release tests were performed by using vertical diffusion Franz cells, and statistically significant different behaviors in terms of the amount and kinetics of drugs released were observed as a function of the construct. Moreover, strong antimicrobial potency (100% of growth inhibition) against Staphylococcus aureus and Pseudomonas aeruginosa was demonstrated depending on the type of construct, offering a proof of concept that 3D printing techniques could be efficiently applied to the production of hydrogels for controlled drug delivery.

Abstract licence: CC BY

Wounds can lead to skin and soft tissue damage and their improper management may lead to the growth of pathogenic bacteria at the site of injury. Identifying better ways to promote wound healing is a major unmet need and biomedical materials with the ability to promote wound healing are urgently needed. Here, we report a thermosensitive black phosphorus hydrogel composed of black phosphorus nano-loaded drug silver sulfadiazine (SSD) and chitosan thermosensitive hydrogel for wound healing. The hydrogel has temperature-sensitive properties and enables the continuous release of SSD under near-infrared irradiation to achieve synergistic photothermal and antibacterial treatment. Additionally, it exerts antibacterial effects on Staphylococcus aureus. In a rat skin injury model, it promotes collagen deposition, boosts neovascularization, and suppresses inflammatory markers. In summary, the excellent thermosensitivity, biocompatibility, and wound-healing-promoting qualities of the reported thermosensitive hydrogel make it suitable as an ideal wound dressing in the clinic.

Abstract licence: CC BY