A simple and effective approach for the treatment of chronic wound infections caused by multiple antibiotic resistant Escherichia coli

Antimicrobial, resistance is a major problem in present-day therapy. Despite the advent of newer antimicrobial agents with a broad spectrum of activity, multiple antibiotic resistant pathogens are difficult to eliminate from infected sites. The present study was carried out to develop an approach, using citric acid as a sole antimicrobial agent, for the treatment of chronic wound infections caused by multiresistant Escherichia coli (MAREC). A total. of 34 cases of chronic wound infections yielding MAREC isolates on culture were studied. The antibacterial effect of citric acid against MAREC was evaluated in vitro by broth dilution method. Three percent citric acid get was applied to each wound once daily until it heated completely. All 34 isolates were inhibited by citric acid with minimum inhibitory concentrations in the range of 1500-2000 mu g/ml. Topical application of 3% citric acid to wounds 7-42 times resulted in elimination of MAREC from infected sites and successful heating of wounds in all. 34 patients. This treatment modality was simple, reliable, non-toxic and effective. Hence, the use of citric acid for the cost-effective treatment of wound infections caused by MAREC is recommended. (C) 2008 The Hospital Infection Society. Published by Elsevier Ltd. All rights reserved.