Comparison of silver-coated dressing (Acticoat®), chlorhexidine acetate 0.5% (Bactigrass®) and nystatin for topical antifungal effect in Candida albicans-contaminated, full-skin-thickness rat burn wounds

Background: In this experimental animal study, the effects of three different topical antimicrobial dressings on Candida albicans contaminated full-thickness burn in rats were analyzed. Methods: In total 32 adult Wistar rats (body weight 200-220 g) were used. Silver-coated dressing (Acticoat (TM)(R)), chlorhexidine acetate 0.5% (Bactigrass (R)) and Mycostatine (Nystatie (R)) were compared to assess the antifungal effect of a once-daily application on experimental rat 15% full-skin thickness burn wound seeded 24 h earlier with a 10(8) CFU/mL standard strain of C. albicans ATCC 90028. All the animals were sacrificed at post burn day 7. The quantitative counts of seeded organism in burn eschar and subjacent muscle were determined, in addition to the cultures of left ventricle blood and lung biopsies. Results: While there were significant differences between Acticoat (TM)(R) group (4 +/- 10 x 10(4)) and control group (5 +/- 6 x 10(6)), and between Nystatin group (4 +/- 4 x 10(4)) and control group (P = 0.01, P = 0.01), there were no significant differences between chlorhexidine acetate 0.5% group (2 +/- 3 x 10(4)) and control group (P = 0.7) respectively. Acticoat (TM)(R) and Nystatin were sufficient to prevent to C. albicans from invading to the muscle and from causing systemic infection. Conclusions: The animal data suggest that nystatin is the most effective agents in the treatment of C. albicans-contaminated burn wounds, and Acticoat (TM)(R) is a choice of treatment on fungal burn wound infection with antibacterial effect and the particular advantage of limiting the frequency of replacement of the dressing. (C) 2011 Elsevier Ltd and ISBI. All rights reserved.