Applying Antimicrobial Strategies in Wound Care Practice: A Review of the Evidence

Abstract

Antimicrobial resistance is increasing due to an overreliance on antimicrobials to treat and manage infections. Chronic wounds are particularly vulnerable to infections and harbour complex microbial communities, increasing the risk of secondary infections caused by antimicrobial resistant bacteria. Accurate and early diagnosis of infection ensures appropriate treatment interventions and a reduction in the likelihood that antibiotic use is required. Despite this, the overuse of antibiotic treatment in wound care is still evident. Antimicrobial stewardship describes a structured approach to managing antimicrobial resistance through educating healthcare professionals about antimicrobial use to improve patient outcomes and minimise the spread of infections. However, the evidence suggests that healthcare professionals experience barriers when attempting to implement such strategies in their practice. It is essential that the principles of antimicrobial stewardship are embedded into wound care treatment and management. This review aimed to explore the current barriers to antimicrobial stewardship in wound care clinical practice and discuss the strategies that can be applied to successfully maximise infection prevention. There is a need to further educate wound care practitioners about antimicrobial stewardship and future research should concentrate on understanding how healthcare professionals can work collaboratively to implement such strategies in their practice.

Keywords: DACC technology; DACC‐coated dressings non‐medicated; acute and chronic wound care; antimicrobial resistance; antimicrobial stewardship; wound dressings.

FIGURE 1

IWII WIC (Reproduced with kind permission from the IWII).

FIGURE 2

Pathway to guide the management of patients with wounds with or without infection considering the principles of antimicrobial stewardship. IV, intravenous. Figure reproduced with permission from Wounds UK Best Practice Statement: Antimicrobial stewardship strategies for wound management. Wounds UK, London.

FIGURE 3

Continuous process for implementing ASPs.