This EWMA Document, published in 2022, provides an update on the controversies and hopes published in the 2013 document: Antimicrobials and Non-healing Wounds. Evidence, Controversies and suggestions.

In addition to the document, you can download a short (one-page) guidance document provinding a consice approach to treating potentially infected wounds. The short guidance was updated in October 2025. Please note that the translated versions of the one-pager have not yet been updated.

The full document aims to:

• Highlight current knowledge regarding the use of antimicrobial agents, particularly in non-healing wounds
• Discuss new information and progress in this field since 2013
• Offer recommendations for future actions
• Provide practical guidance for clinical practice concerning the appropriate use of antibiotics and antiseptics in wound management

Addressing the urgent need for antimicrobial stewardship in wound care

Given the societal value of antimicrobials and their diminishing effectiveness due to antimicrobial resistance, the WHO is now recommending member states to strengthen national stewardship. Still, there are currently no international or coordinated legislative or regulatory mandates designed to optimize the use of antimicrobials through stewardship. However, antimicrobial stewardship programmes are increasingly advocated as means to decrease misuse of antimicrobial agents.

Along with infection prevention and control, hand hygiene, and surveillance, antimicrobial stewardship is considered a key strategy in local and national programmes aiming to prevent the emergence of antimicrobial resistance and decrease preventable healthcare associated infections.

Since 2013, EWMA has taken action and introduced, together with the British Society for Antimicrobial Chemotherapy (BSAC, https://bsac.org.uk/), a tailored stewardship concept to wound care practitioners.