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{{Expert-subject-multiple|Medicine|Pharmacology|date=November 2009}}
{{Expert-subject-multiple|Medicine|Pharmacology|date=November 2009}}


Silver has medical uses as an [[antiseptic]] and a [[disinfectant]]. The [[silver]] [[ion]] (Ag<sup>+</sup>) is [[bioactive]] and in sufficient [[concentration]] readily kills [[bacteria]] [[in vitro]]. Physicians use wound dressings containing [[silver sulfadiazine]] (Ag-SD) or [[Silver nanoparticles|silver nano-materials]] to treat external infections. The disinfectant properties of silver are used in medical applications, such as [[urinary catheter]]s and [[endotracheal tube|endotracheal breathing tubes]], where the silver content is effective in reducing incidences of catheter-related [[bacteriuria]] and ventilator-associated [[pneumonia]] (VAP) respectively.<ref>http://www.ahrq.gov/Clinic/ptsafety/chap15a.htm</ref><ref>{{cite journal
Silver has medical uses as an [[antiseptic]] and a [[disinfectant]]. The [[silver]] [[ion]] (Ag<sup>+</sup>) is [[bioactive]] and in sufficient [[concentration]] readily kills [[bacteria]] [[in vitro]]. Silver also kills bacteria in external wounds in living tissue, and physicians therefore use wound dressings containing [[silver sulfadiazine]] (Ag-SD) or [[Silver nanoparticles|silver nano-materials]] to treat external infections.<ref name="Burns2007">{{cite journal |author=Atiyeh BS, Costagliola M, Hayek SN, Dibo SA |title=Effect of silver on burn wound infection control and healing: review of the literature |journal=Burns |volume=33 |issue=2 |pages=139–48 |year=2007 |pmid=17137719 |doi=10.1016/j.burns.2006.06.010 }}</ref><ref name="nccam">{{cite web| publisher = [[National Center for Complementary and Alternative Medicine]] | title = Colloidal Silver Products | url = http://nccam.nih.gov/health/silver/ |date = December 2006 | accessdate = 2008-10-06}}</ref><ref>http://www3.interscience.wiley.com/journal/118718782/abstract</ref><ref>http://www.theengineer.co.uk/Articles/299472/Combatting%20the%20bug.htm</ref><ref>http://tahilla.typepad.com/mrsawatch/wounds_silver/</ref><ref name="Hermans2006">{{cite journal |author=Hermans MH |title=Silver-containing dressings and the need for evidence |journal=The American journal of nursing |volume=106 |issue=12 |pages=60–8; quiz 68–9 |year=2006|pmid=17133010}}</ref> Wound dressings containing silver are increasing in importance due to the recent increase of antibiotic-resistant bacteria such as methicillin-resistant Staphylococcus aureus.<ref> http://jac.oxfordjournals.org/cgi/content/full/dkm006v2</ref> The disinfectant properties of silver are used in medical applications, such as [[urinary catheter]]s and [[endotracheal tube|endotracheal breathing tubes]], where the silver content is effective in reducing incidences of catheter-related [[bacteriuria]] and ventilator-associated [[pneumonia]] (VAP) respectively.<ref>http://www.ahrq.gov/Clinic/ptsafety/chap15a.htm</ref><ref>{{cite journal
| journal = American Journal of Medicine
| journal = American Journal of Medicine
| volume = 105
| volume = 105
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| doi = 10.1016/S0002-9343(98)00240-X
| doi = 10.1016/S0002-9343(98)00240-X
| pmid = 9753027
| pmid = 9753027
}}</ref><ref>http://jama.ama-assn.org/cgi/content/abstract/300/7/805</ref><ref name="FDA Silver">{{cite web|url= http://www.fda.gov/bbs/topics/NEWS/2007/NEW01741.html| title= FDA Clears Silver-Coated Breathing Tube For Marketing|date= 2007-11-08|accessdate=2007-11-11}}</ref> Silver is also used on surfaces and fabrics to reduce the spread of infection.<ref>{{cite web|title= AGC Flat Glass Europe launches world’s first antibacterial glass|url = http://www.agc-flatglass.eu/AGC+Flat+Glass+Europe/English/Homepage/News/Press+room/Press-Detail-Page/page.aspx/979?pressitemid=1031|date = 2007-09-04}}</ref><ref name="Lansdown2006"/>
}}</ref><ref>http://jama.ama-assn.org/cgi/content/abstract/300/7/805</ref><ref name="FDA Silver">{{cite web|url= http://www.fda.gov/bbs/topics/NEWS/2007/NEW01741.html| title= FDA Clears Silver-Coated Breathing Tube For Marketing|date= 2007-11-08|accessdate=2007-11-11}}</ref> Silver is also used in bone prostheses, reconstructive orthopaedic surgery and cardiac devices,<ref>http://content.karger.com/ProdukteDB/produkte.asp?doi=10.1159/000093928</ref> as well as on surfaces and fabrics to reduce the spread of infection<ref name="Lansdown2006"/><ref> http://www.zeolitanatural.com/docs/antimicrobialsilverzeolite.pdf</ref>


All silver-based products are contra-indicated for people who are allergic to silver.<ref name="Lansdown2006"/> Lansdown also states that "Silver exhibits low toxicity in the human body, and minimal risk is expected due to clinical exposure by inhalation, ingestion, dermal application or through the urological or haematogenous route."<ref>http://content.karger.com/ProdukteDB/produkte.asp?doi=10.1159/000093928</ref> This view is supported by the Agency for Toxic Substances and Disease Registry (ATSDR).<ref>http://www.atsdr.cdc.gov/tfacts146.html</ref><ref>http://www.atsdr.cdc.gov/toxprofiles/tp146-c1.pdf</ref>
⚫
Historically, [[colloid]]al silver, a [[liquid]] [[suspension (chemistry)|suspension]] of [[microscopic]] silver particles,<!--A [[colloid]] is technically defined as particles which remain suspended without forming an [[Ionic liquid|ionic]], or dissolved solution.--> was also used as an internal medication to treat a variety of diseases, however the effectiveness of these treatments continues to remain unproven, and they were discontinued after they had been heavily criticized for causing argyria. [[Argyria]] is a condition in which the skin irreversibly turns blue or grey (from accumulated silver), which can be socially debilitating. Since the 1990s, "colloidal silver" has been marketed as an [[alternative medicine]] product, with unsubstantiated, and some jurisdictions illegal, claims of effectiveness. In some cases, people have developed argyria as a result, and medical authorities<ref name="nccam"/><ref name="mskcc"/> as well as the medical articles dealing with the topic<ref>Fung & Bowden 1996: 124-125</ref> advise against the use of these silver preparations because of their ineffectiveness and potential toxicity.

⚫
Historically, [[colloid]]al silver, a [[liquid]] [[suspension (chemistry)|suspension]] of [[microscopic]] silver particles,<!--A [[colloid]] is technically defined as particles which remain suspended without forming an [[Ionic liquid|ionic]], or dissolved solution.--> was also used as an internal medication to treat a variety of diseases, however the effectiveness of these treatments continues to remain unproven. In the 1940s they were discontinued due to both the development of safe and effective modern antibiotics and concern about argyria and other side effects of silver products.<ref name="Fung/Wadhera2005">Fung / Wadhera 2005</ref><ref name="Fung/Bowen-120">Fung / Bowen 1996: 120.</ref> [[Argyria]] is a condition in which the skin irreversibly turns blue or grey (from accumulated silver), which can be socially debilitating but which is not otherwise harmful. However argyria only occurs due to “Indiscriminate use"<ref> http://www.ncbi.nlm.nih.gov/pubmed/8632503?dopt=Citation</ref> or "Chronic ingestion or inhalation".<ref name="Lansdown2006"/>

Since the 1990s, "colloidal silver" has been marketed as an [[alternative medicine]] product, with unsubstantiated, and some jurisdictions illegal, claims of effectiveness. In some cases, people have developed argyria as a result.{{fact}} Medical authorities<ref>http://www.ncbi.nlm.nih.gov/pubmed/10558603</ref><ref name="nccam"/><ref name="mskcc"/> as well as the medical articles dealing with the topic<ref>Fung & Bowden 1996: 124-125</ref> advise against the use of these silver preparations because of their unproven effectiveness and potential toxicity. Per the EPA, the safe dosage is 5 micrograms (µg) of silver per kilogram (kg) of body weight per day (5 µg/kg/day) - about 350 µg of silver per day for a 70 kg person, or 7 teaspoons at 10ppm '''''per day''''' every day for life, which is over a litre per month.<ref> http://www.fda.gov/Food/DietarySupplements/Alerts/ucm184087.htm</ref><ref> http://www.bestfish.com/convert.html </ref>


==Biological effects of silver==
==Biological effects of silver==

Revision as of 01:33, 23 November 2009

Template:Expert-subject-multiple

Silver has medical uses as an antiseptic and a disinfectant. The silver ion (Ag+) is bioactive and in sufficient concentration readily kills bacteria in vitro. Silver also kills bacteria in external wounds in living tissue, and physicians therefore use wound dressings containing silver sulfadiazine (Ag-SD) or silver nano-materials to treat external infections.[1][2][3][4][5][6] Wound dressings containing silver are increasing in importance due to the recent increase of antibiotic-resistant bacteria such as methicillin-resistant Staphylococcus aureus.[7] The disinfectant properties of silver are used in medical applications, such as urinary catheters and endotracheal breathing tubes, where the silver content is effective in reducing incidences of catheter-related bacteriuria and ventilator-associated pneumonia (VAP) respectively.[8][9][10][11] Silver is also used in bone prostheses, reconstructive orthopaedic surgery and cardiac devices,[12] as well as on surfaces and fabrics to reduce the spread of infection[13][14]

All silver-based products are contra-indicated for people who are allergic to silver.[13] Lansdown also states that "Silver exhibits low toxicity in the human body, and minimal risk is expected due to clinical exposure by inhalation, ingestion, dermal application or through the urological or haematogenous route."[15] This view is supported by the Agency for Toxic Substances and Disease Registry (ATSDR).[16][17]

Historically, colloidal silver, a liquid suspension of microscopic silver particles, was also used as an internal medication to treat a variety of diseases, however the effectiveness of these treatments continues to remain unproven. In the 1940s they were discontinued due to both the development of safe and effective modern antibiotics and concern about argyria and other side effects of silver products.[18][19] Argyria is a condition in which the skin irreversibly turns blue or grey (from accumulated silver), which can be socially debilitating but which is not otherwise harmful. However argyria only occurs due to “Indiscriminate use"[20] or "Chronic ingestion or inhalation".[13]

Since the 1990s, "colloidal silver" has been marketed as an alternative medicine product, with unsubstantiated, and some jurisdictions illegal, claims of effectiveness. In some cases, people have developed argyria as a result.[citation needed] Medical authorities[21][2][22] as well as the medical articles dealing with the topic[23] advise against the use of these silver preparations because of their unproven effectiveness and potential toxicity. Per the EPA, the safe dosage is 5 micrograms (µg) of silver per kilogram (kg) of body weight per day (5 µg/kg/day) - about 350 µg of silver per day for a 70 kg person, or 7 teaspoons at 10ppm per day every day for life, which is over a litre per month.[24][25]

Biological effects of silver

Further information: Silver and Argyria

Silver and silver compounds have an oligodynamic effect and are toxic for bacteria, algae and fungi in vitro. The oligodynamic effect is typical for heavy metals like lead or mercury, but among the elements that have this effect, silver is the least toxic for humans. It is established that the antibacterial action of silver is dependent on the silver ion.[13] The effectiveness of silver compounds as an antiseptic is based on the ability of the biologically active silver ion (Ag+) to irreversibly damage key enzyme systems in the cell membranes of pathogens.[13]

It has long been known that antibacterial action of silver is enhanced by the presence of an electric field. Applying a few volts of electricity across silver electrodes drastically enhances the rate that bacteria in solution are killed. It has been discovered that the antibacterial action of silver electrodes is greatly improved if the electrodes are covered with silver nanorods.[26]

In animals and humans, silver accumulates in the body.[27] Chronic intake of silver products can result in an accumulation of silver or silver sulfide particles in the skin. As in photography (where silver is used due to its reactivity with light), these particles in the skin darken with exposure to sunlight, resulting in a blue or gray discoloration of the skin. This condition is known as argyria; similarly, it can lead to silver in the eye (argyrosis) and in other organs.[13] Localized argyria can occur as a result of topical use of substances containing silver, while generalized argyria results from the ingestion of such substances.[28] Argyria is usually permanent, and there is no known effective treatment;[28] the only practical method of minimizing its cosmetic disfigurement is avoiding the sun.[29] The Agency for Toxic Substances and Disease Registry (ATSDR) describes argyria as a "cosmetic problem",[30], but medical literature from 1935 and 1940, when argyria occurred as an adverse reaction to colloidal silver preparations prescribed by physicians, emphasise it is socially debilitating.[31][32] While argyria is usually benign and limited to skin discoloration, there are isolated reports of more serious neurologic, renal, or hepatic complications.[28][33] One death has been reported in the medical literature which the authors felt was due to silver toxicity. In that case a 71-year-old man developed status epilepticus after repeated oral ingestion of colloidal silver.[34]

Generally, "silver exhibits low toxicity in the human body, and minimal risk is expected due to clinical exposure,"[13] when silver or silver compounds are used in the treatment of external infections or in medical appliances. The reference dose, published by the United States Environmental Protection Agency in 1991, which recommends the estimated daily exposure which is unlikely to incur a appreciable risk of deleterious effects during a lifetime, is 5 µg/kg/d; meaning 5 microgram of silver per kilo of weight per person each day – about 1 liter of 10 ppm colloidal silver per month for a 66kg person.[35]

Colloidal silver preparations primarily deliver inactive metallic silver, rather than the active microbicidal silver ion.[29] There is no scientific evidence to support the effectiveness of colloidal silver in vivo.[2] Some in vitro studies demonstrate an anti-bacterial effect of colloidal silver,[36] although one study in 2004 of a colloidal silver solution marketed on the Internet showed no such antimicrobial activity.[37]

Use as disinfectant and antiseptic

Hippocrates, the "father of medicine",[38] wrote that silver had beneficial healing and anti-disease properties.[39] In the early 1900s, silver gained regulatory approval as an antimicrobial agent. Prior to the introduction of antibiotics, colloidal silver was used as a germicide and disinfectant.[40] With the introduction of antibiotics in the 1940s the use of silver as an antimicrobial agent diminished.[41] Subsequently, colloidal silver was replaced by other, more effective silver compounds.

Use as disinfectant

File:Silver Goblets - Emma-Kate Francis.jpg
Handforged silver wine goblets. Usage of silverware was encouraged by the antibiotic action of silver

The Phoenicians are said to have stored water, wine, and vinegar in silver bottles to prevent spoiling.[39] In the early 1900s people would put silver dollars in milk bottles to prolong the milk's freshness.[39]

Electrolytically dissolved silver has been used as a water disinfecting agent. Silver was added as a disinfectant to the drinking water supplies of Russian Mir orbital station and the International Space Station.[42] The World Health Organization includes silver in a colloidal state produced by electrolysis of silver electrodes in water, and colloidal silver in water filters as two of a number of water disinfection methods specified to provide safe drinking water in developing countries.[43] Along these lines, a ceramic filtration system coated with silver particles has been created by Ron Rivera of Potters for Peace and used in developing countries for water disinfection.[44][45][46]

Silver compounds in the treatment of external infections

In World War I, before the advent of antibiotics, silver compounds were used to prevent and treat infections. Silver compounds continue to be used in external preparations as antiseptics,[22] including silver nitrate which can be used in dilute solution as eyedrops to prevent conjunctivitis in newborn babies. Silver nitrate is also sometimes used in dermatology in solid stick form as a caustic ("lunar caustic") to treat certain skin conditions such as corns and warts.[2]

According to Atiyeh et al. (2007), "The gold standard in topical burn treatment is silver sulfadiazine (Ag-SD), a useful antibacterial agent for burn wound treatment". They do note however that silver-impregnated dressings do sometimes result in a slower healing process.[1] Silver sulfadiazine cream (SSD Cream) replaced colloidal silver as the most common delivery system for using silver on the surface of burn wounds to control infection in the 1970s.[1][2]

The US Food and Drug Administration has approved the use of a range of different silver-impregnated wound dressings.[47]

Laboratory studies at the Biochemical Materials Research and Development Center of Jiaxing College, China, have shown that silver-containing alginate fibres provide a sustained release of silver ions when in contact with wound exudates, and are “highly effective against bacteria”.[48] A study administered by the Hull York Medical School found that an antimicrobial barrier dressing containing silver provided “a highly effective and reliable barrier to the spread of MRSA into the wider hospital.”[49] [50]

More recently, dressings incorporating nanocrystalline silver or activated silver-impregnated substances have become available,[1] which deliver higher concentrations of the active silver ion.[13] As of 2006, more "than 10 dressings containing pure silver" were available.[6] In particular, silver is being used with alginate, a naturally occurring biopolymer derived from seaweed, in a range of products designed to prevent infections as part of wound management procedures, particularly applicable to burn victims.[6]

Wound dressings containing silver are increasing in importance due to the increase of antibiotic-resistant bacteria, which has imposed clinical limits on the use of antibiotics. Chopra[51] states that topical silver is regaining popularity in the management of open wounds, “due largely to the spread of methicillin-resistant Staphylococcus aureus and the resultant reduction in first-line antibiotic prescribing”. Chopra also expresses the concern that “There is a need for silver MIC levels and breakpoints to be developed and standardized.” He does however conclude that “Some silver-based dressings appear to provide an effective alternative to antibiotics in the management of wound infection.” [41]

Silver has proven antimicrobial activity that includes antibiotic-resistant bacteria. It has a broad spectrum of antimicrobial activity, with minimal toxicity toward mammalian cells at low concentrations, and has a less likely tendency than antibiotics to induce resistance due to its activity at multiple bacterial target sites.[52][53][54][41][55] However, some sources still hold that the evidence for the effectiveness of silver-treated dressings is mixed, as the evidence is marred by the poor quality of the trials used to assess these products.[56] Consequently a major systematic review by the Cochrane Collaboration found insufficient evidence to recommend the use of silver-treated dressings to treat infected wounds.[56]

An article from the National Center for Complementary and Alternative Medicine points out that silver nitrate and silver sulfadiazine can have negative side effects, and that they must be applied to the body externally and not taken internally.[2] However according to Lansdown, the risk expected due to clinical exposure to silver is "minimal", as only chronic ingestion or inhalation of silver preparations leads to an accumulation of silver in the human body that can cause argyria, argyrosis (accumulation of silver in the eye) and other conditions.[13] Silver-based products are contra-indicated for people who are allergic to silver.[13]

Silver compounds in medical appliances

The disinfectant properties of silver are used in some other medical applications, such as catheters and endotracheal breathing tubes.[57][58] The use of these devices is contraindicated for persons who are allergic to silver,[13] and no thorough testing and standardization of these products has yet been undertaken.[41] According to Lansdown (2006), the risk expected due to clinical exposure to silver is "minimal".[13] Only chronic ingestion or inhalation of silver preparations leads to an accumulation of silver in the human body and can cause argyria, argyrosis (accumulation of silver in the eye) and other conditions.[13]

A study on the use of silver-alloy catheters by the University of Michigan School of Medicine concluded that “The data supporting the use of silver alloy urinary catheters to reduce urinary catheter-related bacteriuria is reasonably strong.”[59] The study also concluded that silver alloy catheters are more effective than standard catheters for reducing bacteriuria in adults in hospital having short term catheterization, and that although they cost about $6 more than standard urinary catheters, they may be worth the extra cost since catheter-related infection is a common cause of nosocomial infection and bacteremia. Related meta-analysis also clarified discrepant results among earlier trials of silver-coated urinary catheters by revealing that silver alloy catheters are significantly more effective in preventing urinary tract infections than are silver oxide catheters.[60] These conclusions are supported by, among others, studies by the University Hospitals Leuven, Belgium[13] and the University Hospital for Anesthesiology and Surgical Intensive Care, Halle, Germany.[61][62]

In 2007, AGC Flat Glass Europe introduced the first antibacterial glass to fight hospital-caught infection: it is covered with a thin layer of silver.[63] Ionizable silver is also incorporated into fabrics to reduce the spread of bacteria.[13]

Ventilator-associated pneumonia (VAP) causes substantial morbidity. A 2008 study by Kollef et al concluded that “Patients receiving a silver-coated endotracheal tube had a statistically significant reduction in the incidence of VAP and delayed time to VAP occurrence compared with those receiving a similar, uncoated tube.” [64] In addition, the U.S. Food and Drug Administration (FDA) has recently approved an endotracheal breathing tube with a fine coat of silver for use in mechanical ventilation, after studies found it reduced the risk of ventilator-associated pneumonia.[11]

Other medical uses

Historical applications

Silver has had some medicinal uses going back for centuries. Physicians used it as an eyedrop for ophthalmic problems,[65] for various infections,[66][67] and sometimes internally for diseases such as tropical sprue, epilepsy, gonorrhea, and the common cold.[2][22][68] In the 1940s, however, the medical use of silver diminished, due to both the development of safe and effective modern antibiotics and concern about argyria and other side effects of silver products.[18][19] The total number of people who developed argyria as a result of colloidal silver preparations described by physicians is unknown. Fung & Bowden point out there were 365 cases of argyria from 1802 to 1951 reported in the medical literature by 1971 in total,[69] but this number would also include cases of argyria due to other kinds of exposure to silver.

The use of colloidal silver preparations (CSP) to treat or prevent "gonorrhea and gonorrheal conjunctivitis due to purported bacteriocidal properties" has largely been replaced "by less toxic antimicrobials with substantiated effectiveness."[19] Considering "direct application to mucous membranes in the nose, throat, urethra, and colon", there is "no evidence that CSP [colloidal silver preparations] are effective at these other sites and toxicity has been reported."[19] Although "silver products were infrequently promoted for oral use, benefits have been even more questionable."[19]

Current alternative medicine use

From approximately 1990 there has been a resurgence of the promotion of colloidal silver as an alternative medicine treatment, marketed with claims of it being an essential mineral supplements or that it can prevent or treat numerous diseases like cancer, diabetes, HIV/AIDS, and herpes, [70] as well as tuberculosis.[2] Although colloidal silver products are legally available at health food stores in the United States and Australia and are marketed over the Internet as a dietary supplement, it is illegal in the U.S. and Australia for marketers to make such claims of medical effectiveness for colloidal silver. There is no medical evidence that colloidal silver is effective for any of these claimed indications.[71][72] Silver is not an essential mineral in humans; there is no dietary requirement for silver, and no such thing as a silver "deficiency".[2]

The commercial product referred to as "colloidal silver", includes solutions that contain various concentrations of ionic silver compounds, silver colloids or silver compounds bound to proteins in water. Such products with concentrations of 30 parts per million (ppm) or less are typically manufactured using an electrolysis process, whereas those with higher concentrations of 50 ppm or more are usually silver compounds that have been bound with a protein. These solutions are currently marketed for internal and external use as an alternative medical remedy though there is no scientific evidence to support its effectiveness in vivo.[2]

Currently, there are no evidence-based medical uses for ingested colloidal silver. There are no clinical studies in humans demonstrating effectiveness, and a few reports of toxicity.[22] The U.S. National Center for Complementary and Alternative Medicine has issued an advisory indicating that the marketing claims made about colloidal silver are scientifically unsupported, and that the silver content of marketed supplements varies widely and that colloidal silver products can have serious side effects to the consumer, including "argyria,... neurologic problems (such as seizures), kidney damage, stomach distress, headaches, fatigue, and skin irritation. Colloidal silver may interfere with the body's absorption of some drugs, such as penacillamine, quinolones, tetracyclines, and thyroxine."[2]

A number of case reports describe argyria after ingestion of colloidal silver marketed as an alternative-medicine treatment.[29][28][18][73] Colloidal silver may theoretically reduce the absorption of some medications, including tetracycline and quinolone antibiotics and penicillamine, thereby reducing the effectiveness of those medications.[22]

Government regulation

In August 1999, the U.S. Food and Drug Administration (FDA) banned colloidal silver sellers from claiming any therapeutic or preventive value for the product, noting that colloidal silver was being marketed for numerous diseases without evidence of safety or effectiveness.[72] Before issuing its decision, the FDA requested comments and evidence from the public and from marketers of colloidal silver. In response, the FDA received isolated case reports and testimonials from marketers and consumers, but did not receive any scientific evidence. The FDA concluded: "None of the comments presented any evidence of safety or effectiveness beyond personal experience."[72] As a result, the product now has the status of a dietary supplement in the US; it can be promoted with general "structure-function" claims, but cannot be marketed as preventing or treating any illness.[72] Following this ruling, the FDA has issued numerous warnings to Internet sites which have continued to promote colloidal silver as an antibiotic or for other medical purposes.[74][75]

In 2002, the Australian Therapeutic Goods Administration (TGA) found that there were no legitimate medical uses for colloidal silver and no evidence to support its marketing claims. Given the associated safety risks, the TGA concluded that "efforts should be made to curb the illegal availability of colloidal silver products, which is a significant public health issue."[76]

Literature

  • Fung MC, Bowen DL (1996). "Silver products for medical indications: risk-benefit assessment". J. Toxicol. Clin. Toxicol. 34 (1): 119–26. doi:10.3109/15563659609020246. PMID 8632503.
  • Wadhera A, Fung M (2005). "Systemic argyria associated with ingestion of colloidal silver". Dermatol. Online J. 11 (1): 12. PMID 15748553.

References

  1. ^ a b c d Atiyeh BS, Costagliola M, Hayek SN, Dibo SA (2007). "Effect of silver on burn wound infection control and healing: review of the literature". Burns. 33 (2): 139–48. doi:10.1016/j.burns.2006.06.010. PMID 17137719.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  2. ^ a b c d e f g h i j k "Colloidal Silver Products". National Center for Complementary and Alternative Medicine. December 2006. Retrieved 2008-10-06.
  3. ^ http://www3.interscience.wiley.com/journal/118718782/abstract
  4. ^ http://www.theengineer.co.uk/Articles/299472/Combatting%20the%20bug.htm
  5. ^ http://tahilla.typepad.com/mrsawatch/wounds_silver/
  6. ^ a b c Hermans MH (2006). "Silver-containing dressings and the need for evidence". The American journal of nursing. 106 (12): 60–8, quiz 68–9. PMID 17133010.
  7. ^ http://jac.oxfordjournals.org/cgi/content/full/dkm006v2
  8. ^ http://www.ahrq.gov/Clinic/ptsafety/chap15a.htm
  9. ^ Sanjay Saint, MD, MPH; Joann G. Elmore, MD, MPH; Sean D. Sullivan, PhD; Scott S. Emerson, MD, PhD; Thomas D Koepsell, MD, MPH (1998). "The efficacy of silver alloy-coated urinary catheters in preventing urinary tract infection: a meta-analysis". American Journal of Medicine. 105 (3): 236–241. doi:10.1016/S0002-9343(98)00240-X. PMID 9753027. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  10. ^ http://jama.ama-assn.org/cgi/content/abstract/300/7/805
  11. ^ a b "FDA Clears Silver-Coated Breathing Tube For Marketing". 2007-11-08. Retrieved 2007-11-11.
  12. ^ http://content.karger.com/ProdukteDB/produkte.asp?doi=10.1159/000093928
  13. ^ a b c d e f g h i j k l m n o Lansdown AB (2006). "Silver in health care: antimicrobial effects and safety in use". Current Problems in Dermatology. 33: 17–34. doi:10.1159/000093928. PMID 16766878.
  14. ^ http://www.zeolitanatural.com/docs/antimicrobialsilverzeolite.pdf
  15. ^ http://content.karger.com/ProdukteDB/produkte.asp?doi=10.1159/000093928
  16. ^ http://www.atsdr.cdc.gov/tfacts146.html
  17. ^ http://www.atsdr.cdc.gov/toxprofiles/tp146-c1.pdf
  18. ^ a b c Fung / Wadhera 2005
  19. ^ a b c d e Fung / Bowen 1996: 120.
  20. ^ http://www.ncbi.nlm.nih.gov/pubmed/8632503?dopt=Citation
  21. ^ http://www.ncbi.nlm.nih.gov/pubmed/10558603
  22. ^ a b c d e "About Herbs: Colloidal Silver". Memorial Sloan-Kettering Cancer Center. 2008-07-25. Retrieved 2008-10-03.
  23. ^ Fung & Bowden 1996: 124-125
  24. ^ http://www.fda.gov/Food/DietarySupplements/Alerts/ucm184087.htm
  25. ^ http://www.bestfish.com/convert.html
  26. ^ O. Akhavan and E. Ghaderi (2009). "Enhancement of antibacterial properties of Ag nanorods by electric field" (free download pdf). Sci. Technol. Adv. Mater. 10: 015003. doi:10.1088/1468-6996/10/1/015003.
  27. ^ Fung / Bowen 1996: 121.
  28. ^ a b c d Brandt D, Park B, Hoang M, Jacobe HT (2005). "Argyria secondary to ingestion of homemade silver solution". J. Am. Acad. Dermatol. 53 (2 Suppl 1): S105–7. doi:10.1016/j.jaad.2004.09.026. PMID 16021155. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  29. ^ a b c Okan D, Woo K, Sibbald RG (2007). "So what if you are blue? Oral colloidal silver and argyria are out: safe dressings are in". Adv Skin Wound Care. 20 (6): 326–30. doi:10.1097/01.ASW.0000276415.91750.0f. PMID 17538258. Colloidal silver suspensions are solutions of submicroscopic metallic silver particles suspended in a colloid base. These products deliver predominantly inactive metallic silver, not the antimicrobial ionized form. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  30. ^ ToxFAQs™: Silver
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External links

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