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All Journal Nurse Media Journal of Nursing Manuju : Malahayati Nursing Journal Journal of Applied Nursing (Jurnal Keperawatan Terapan) Viva Medika: Jurnal Kesehatan, Kebidanan dan Keperawatan Jurnal Keperawatan Malang (JKM) JURNAL PENELITIAN PERAWAT PROFESIONAL Indonesian Journal of Global Health research Jurnal Kesehatan Tambusai Jurnal Ilmiah Wahana Pendidikan Journal of Management Nursing Jurnal Ekonomi, Teknologi dan Bisnis Jurnal Keperawatan Soedirman (The Soedirman Journal of Nursing) Madani: Multidisciplinary Scientific Journal Java Nursing Journal Jurnal Inovasi Global Jurnal Keperawatan Profesional Jurnal Pengabdian dan Pemberdayaan Kesehatan
Burhan, Asmat
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Journal : Java Nursing Journal

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A Clean Fight: Comparing Metronidazole and Silver Sulfadiazine Gels in Treating Infected Diabetic Foot Ulcers: A Randomized Control Trial Romano, Giulia; More, Claire; Garnier, Élodie; Fernández Navarro, Lucía; Burhan, Asmat
Java Nursing Journal Vol. 3 No. 3 (2025): July - October 2025
Publisher : Global Indonesia Health Care (GOICARE)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.61716/jnj.v3i3.115

Abstract

Background: Diabetic foot ulcers (DFUs) are a major cause of morbidity and non-traumatic amputations among patients with diabetes. Infection delays healing and increases the risk of severe complications, underscoring the need for effective topical treatments. Objective: To compare the efficacy of topical Metronidazole versus Silver Sulfadiazine (SSD) in promoting wound healing in infected DFUs, and to evaluate the influence of systemic markers, including HbA1c, CRP, and albumin, on treatment outcomes. Methods: This randomized, double-blind controlled trial was conducted at the Centre Médical de Saint-Jean-sur-Veyle from April to June 2025. Ninety adult patients with mild-to-moderate infected DFUs were randomly assigned to either Metronidazole or SSD. Patients with severe infection, osteomyelitis, or severe ischemia were excluded. Participants received daily topical application of either 1% Metronidazole or 1% SSD gel for four weeks, alongside standard care including debridement, offloading, and glycemic control. The primary outcome was complete wound healing at 4 weeks. Secondary outcomes included wound size reduction, time to healing, and changes in infection severity scores. Subgroup analyses assessed the impact of clinical covariates on healing. Results: Among 90 participants, 86 completed the trial. The Metronidazole group had a significantly higher healing rate (86.7%) compared with the SSD group (68.9%; p = 0.011). ANCOVA showed a significant treatment effect on wound size (F = 6.89; p = 0.011). GEE analysis identified a significant time-by-treatment interaction (OR = 3.06; p = 0.002). Poor healing was associated with wound size ≥5 cm², HbA1c ≥8%, CRP ≥10 mg/L, and albumin <3.5 g/dL. Conclusions and Relevance: Metronidazole was more effective than SSD in promoting short-term wound healing in infected DFUs. It may be considered a preferred topical agent, especially in settings with high anaerobic burden and limited resources.
Co-Authors Achmad Fadilah, Rizal Adelia, Putri Mewa Adriani, Prasanti Afrilya, Tiara Octa Agustriliani, Ricke Pramesti Alverina, Frianca Angin, Sandri E Perangin Ania, Fegy Indahliani Anisa, Putri Anton Suhendro Anwar, Harits Abdurahman Area Dhiatamaa, Sketsa Arlena, Norma Assyifa, Ibnu Atfat Malic, Rohan Athena, Aegle Atwood, Margaret Auron, Afrodita Ayu Kartika Sari, Venna Azzakiyah, Kholifah Nur Baroki Saragih, M.Nuhas Christy, Bunga Diputera, Vi Paradise Dutta Roy, Ananya Dwi Agus Yulianto Dwi Novitasari Dwi Wahyuni Effan Fahri Mahendra, Rahmad EKO YULIANTO Ellangga, Mohammad Wahyu Fauzan, Dipa Hilmi Fauzan, M. Fauzan Abdallah Fernández Navarro, Lucía Garnier, Élodie Habsah Jumma, Misbachul Hayati Hamka Hamka, Hamka Hani, Winarni Hari Perkasa, Tubagus Heri Susanti, Indri Heri Wibowo, Tophan Hidayat, Riski Indah Susanti Indra, Indra pranata Indri Heri Susanti, Indri Heri Iqbal Ramadhan, Iqbal KHOFIFAH Kim Chi, Do Thi Kumala Dewi, Feti Kurniawan, Adytia Linda Yanti Lintang Suryani, Roro Lova, Anggita Noprati M. Norrström, Elin Made Suandika Manurung, Noritha Maria Seraph, Nero Mixrova Sebayang, Septian More, Claire mutia, lisa Narendra, Gangsar Haryo Natasya Edward, Marry Nika, Fifi Sephia Nova Handayani, Rahmaya Nurdiamsyah, Pratomo Nurul, Nurul Hidayati Oanh, Lê Thị Kim Paulus Subiyanto Permata, Pramudya Putra Pramesti Dewi Pramudya Gurensky, Ganea Pratiwi, Syavira Salsabilah Putri Nola R. MacLeod, Emily Rahmaya Nova Handayani Ramadhanti, Rindu Insyra Ramdani, Egi Hilmi Refa Teja Muti Rizki Ayu W Romano, Giulia Romdani, Rifki Maulana Ruangdet, Kritsada Rudi Gunawan Sarumpaet, Pitri Sebayang, Septian Mixrova Sebayar, Septian Mixrova shelina , shelina Silva, Vanessa A Breu Da Suhendro Suhendro Suryani, Roro Lintang Susanto, Amin Syafiqah, Nurul Tarsono Tarsono Tin Utami Tri Mulyono Tri Yudono, Danang Triyadi, Ficky Triyudono, Danang Utami, Firda Aulia Putri Vijay Kumar Wardani, Intan Putri Yumanita Wibowo, Tophan Heri Wijayanti, Indri Wilis Sukmaningtyas Yanrin, Adzana Salsabila Nezga Pratama Yantoro, Awal Tunis