Table 5 Principles for use of antibiotics/antimicrobials in wound treatment

Topical agents

• Restrict the use to critically colonized and infected wounds

• Prefer agents which do not have a systemic formulation (e.g. fusidic acid, mupirocin)

• Use for short periods and rotate to avoid resistances and sensitizations

• Consider retapamulin as a second line treatment for resistant Gram positive bacteria

Systemic agents

• Administer in multiple infected lesions

• Start early in malnourished and/or non compliant patients and in infants

• Prescribe antibiotics according to the result of culture

• Prefer narrow spectrum antibiotics