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Related Experiment Video

Updated: Feb 24, 2026

Come to the Light Side: In Vivo Monitoring of Pseudomonas aeruginosa Biofilm Infections in Chronic Wounds in a Diabetic Hairless Murine Model
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Systemic antibiotics for treating malignant wounds.

Darshini A Ramasubbu1, Valerie Smith, Fiona Hayden

  • 1Dental Department, HSE, Kilbarrack Dental Clinic, Foxfield Crescent, Dublin, Ireland, D5.

The Cochrane Database of Systematic Reviews
|August 25, 2017
PubMed
Summary

Systemic antibiotics, like metronidazole, may not significantly reduce odor in malignant wounds. A single study showed uncertain effects due to high bias and small sample size, necessitating further research.

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Area of Science:

  • Oncology
  • Palliative Care
  • Evidence-Based Medicine

Background:

  • Malignant wounds are a distressing complication of advanced cancer, often presenting with symptoms like pain, exudate, and malodor.
  • These wounds require palliative care focused on symptom management, including odor control and infection reduction.
  • Bacterial proliferation in malignant wounds necessitates effective antibiotic therapy to alleviate symptoms and promote healing.

Purpose of the Study:

  • To evaluate the efficacy of systemic antibiotics in managing malignant wounds.
  • Specifically, to assess the impact of systemic antibiotics on wound-related symptoms such as malodor.

Main Methods:

  • A systematic review was conducted, searching multiple electronic databases up to March 2017.
  • Inclusion criteria focused on randomized controlled trials (RCTs) assessing systemic antibiotics for malignant wounds.
  • One prospective, double-blind, cross-over trial comparing metronidazole with placebo for malignant wound odor was included.

Main Results:

  • The single included study involved six participants and assessed malodor and adverse effects.
  • Results indicated a potential reduction in malodor with metronidazole, but the evidence quality was very low due to high attrition bias and small sample size.
  • No adverse effects were reported for metronidazole or placebo.

Conclusions:

  • The effectiveness of systemic metronidazole for reducing malodor in malignant wounds remains uncertain.
  • The current evidence is limited by a single, high-risk-of-bias study with a very small sample size, primarily in breast cancer patients.
  • Further research is required to investigate the effects of systemic antibiotics on quality of life, pain, exudate, and tumor containment in malignant wounds.