Which of the following statement(s) is/are true concerning the role of antibiotics in wound care?
A. Systemic antibiotics are indicated for all open wounds B. Bacterial resistance can occur with systemic but not topical antibiotics C. An indication for systemic antibiotic administration is a granulation tissue bacterial count in excess of greater than 105 organisms/gram of tissue on quantitative analysis D. Silver sulfadiazine is useful only for the management of burns
An indication for systemic antibiotic administration is a granulation tissue bacterial count in excess of greater than 105 organisms/gram of tissue on quantitative analysis-the role of antibiotics in wound care is controversial. all open wounds are colonized with bacteria. only when surrounding tissue is invaded (cellulitis) are systemic antibiotics clearly indicated. antibiotics may also be useful in other situations such as when granulation tissue has a high bacterial count (> 105 organisms/gram tissue), or in the case of reduced resistance to bacteria such as in a diabetic foot ulcer. the routine use of systemic antibiotics for chronic wounds should be avoided to reduce the development of resistant bacterial strains within the wound. topical ointments are frequently used and can be useful. the topical vehicle may help keep the wound moist and the bacterial count in the wound may be lowered as the result. however, as with most antibiotics, resistant organisms quickly emerge. silver sulfadiazine, frequently used for burn care, is also useful for chronic wounds. its broad spectrum of activity, lack of relevant drug-resistant plasmids in bacteria, and its low cost make it a good choice.