What is the evidence that there is antimicrobial resistance associated with the use of topical antimicrobial preparations

Aims This review aimed to examine the effect of using topical antimicrobial preparations on antimicrobial resistance (AMR) by critically evaluating the currently available evidence.
Method Using systematic review methodology, we considered original research studies employing a prospective design and written in English. The search was conducted in July 2022 using Ovid MEDLINE, Ovid EMBASE Medline and CINAHL databases. Data were extracted using a pre-designed extraction tool and all included studies were quality appraised using the Evidence Based Literature (EBL) appraisal checklist.
Results A total of 375 studies were identified, with 25 meeting the inclusion criteria. Studies were conducted between 1998 and 2021. Half of the studies included explored the use of silver in dressings as an antimicrobial. Two studies were performed in a hospital setting, one study employed an in vitro and in vivo design, with all remaining studies employing an in vitro approach.
Conclusion There was limited evidence of the effect of topical antimicrobial preparations on AMR, with most included studies exploring the effectiveness of topical antimicrobials on infection and wound healing. AMR remains an important issue for exploration and understanding to clearly determine whether topical antimicrobials contribute to AMR.