Acute Wound Antimicrobial Stewardship

Antibiotics have been a source of increasing concern and subsequent regulation among providers, especially those within wound care. Antimicrobial stewardship has been emphasized within the medical system in recent years as antibiotic-resistant organisms have increased globally and among at-risk patient populations.

The discovery of antibiotics has been associated with extending the human lifespan by 23 years. This phenomenon began in the 1900s and peaked in the 1950s, known as the "golden era" of antibiotics due to the rapid release of new antibiotic classes coupled with limited resistance. However, the gradual increase in antimicrobial resistance and associated infectious disease morbidity and mortality threatens to return the world to a post-antibiotic state where routine surgeries and minor infections become life-threatening.

On the surface, topical antibiotics may appear to be a safe choice for some wounds, even some infected wounds, when compared to oral or intravenous options. A seemingly less dangerous adverse effect profile, less invasive nature, and potential for cost-effectiveness are logical, appealing features of topical antibiotics. However, a closer look reveals that the choice is not that simple, and, in fact, clinicians must take several points into consideration.

Abscess: Inflamed tissue surrounding a localized gathering of pus, often caused by infection. Antimicrobial resistance: The process that occurs when bacteria, fungi, and parasites (microorganisms) change over time and no longer respond to antimicrobial medications. This resistance makes it more difficult to treat infections and increases the risk of spreading diseases that result in severe illness and death. Antimicrobial stewardship: Collective measures that are taken to slow the evolution of multidrug-resistant organisms.

Antibiotics have been a source of increasing concern and subsequent regulation among providers, especially those within wound care. Antimicrobial stewardship has been emphasized within the medical system in recent years as antibiotic-resistant organisms have increased globally and among at-risk patient populations.