The Effects of Topically Applied Nitrofurazone and Rifamycin on Wound Healing

Mutlu Saydam, MD; Sarper Yilmaz, MD; Ergin Seven, MD; Ali Riza Erçöçen, MD; Serkan Saydam, PhD; Hafize Sezer, PhD

Disclosures

Wounds. 2006;18(3):71-76. 

In This Article

Discussion

There is no data in the literature on the use of the combination of nitrofurazone and rifamycin in wound care. The only report, written by the authors of the present study, demonstrated the in-vitro efficacy of a combination of nitrofurazone and rifamycin.[6] Several recent reports showed the negative influence of nitrofurazone on wound healing.[7,8,9] However, some contradiction about the effect of nitrofurazone ointment on wound healing exists. In some studies, nitrofurazone ointment was utilized as a standard agent for comparison of different agents.[10] The authors could not locate an experimental study on the effect of rifamycin on wound healing. The only report found in the literature is the abstract of a French manuscript. In that particular study, the effect of topical rifamycin on 268 patients with hand injuries requiring surgery was evaluated. The result favored the use of rifamycin over povidone iodine, and increased healing was observed with topical rifamycin.[5]

In the present study, the authors found that although isolated use of nitrofurazone caused delay in wound healing in the full-thickness wound model, combined use of nitrofurazone with rifamycin did not cause a delay in wound healing. Rifamycin eliminated the retardation effect of nitrofurazone. This is an interesting finding that requires further research. Rifamycin may have chemically blocked some of the nitrofurazone features that caused a delay in healing.

Nitrofurazone is nearly abandoned in European countries and in the United States because of its hypersensitivity reactions. However, in a recent study, it was shown that the rate of hypersensivity reactions was 2% in patients with surgical and traumatic wounds.[11]

Nitrofurazone is an inexpensive broad-spectrum antibacterial agent. A disadvantage of nitrofurazone is the resistance of Pseudomonas aeruginosa to this drug. However, when it is combined with rifamycin, P aeruginosa apparently becomes susceptible to this combination.[6]

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