Clinical Efficacy of Rifampicin Nanoparticle Local Delivery in Post-Surgical Wound Infections Caused by Resistant Bacteria

Bushra Rasool; Hijab Zahra; Aramish Iqbal; Muhammad Azhar; Sana Ahmed; Rafia Arshad

doi:10.61919/xrpzj971

Authors

Bushra Rasool MPhil, Department of Microbiology and Molecular Genetics, Bahauddin Zakariya University, Multan, Pakistan Author
Hijab Zahra MPhil, Department of Microbiology and Molecular Genetics, Bahauddin Zakariya University, Multan, Pakistan. Author
Aramish Iqbal PGR, HFH, Rawalpindi, Pakistan Author
Muhammad Azhar Professor of Surgery, Wah Medical College, National University of Medical Sciences (NUMS), Wah Cantonment, Pakistan Author
Sana Ahmed Lecturer Inorganic Chemistry, Department of Chemistry, Faculty of Basic Sciences, Sardar Bahadur Khan Women University, Quetta, Pakistan. Author
Rafia Arshad Final Year MBBS, Baqai Medical University, Karachi, Pakistan Author https://orcid.org/0009-0004-3824-7057

DOI:

https://doi.org/10.61919/xrpzj971

Keywords:

Antibacterial Agents; Drug Delivery Systems; Nanoparticles; Postoperative Wound Infection; Rifampicin; Randomized Controlled Trial; Wound Healing

Abstract

Background: Post-surgical wound infections caused by resistant bacteria remain difficult to manage because conventional antimicrobial strategies may provide inadequate local drug exposure, delayed bacterial clearance, frequent dressing requirements, and prolonged wound healing. Nanoparticle-based local antibiotic delivery may improve wound-site drug retention while reducing treatment burden. Objective: To evaluate the clinical efficacy and local tolerability of rifampicin nanoparticle dressing in adults with culture-confirmed resistant post-surgical wound infections. Methods: A parallel-group randomized controlled trial was conducted in a tertiary care surgical unit in Central Punjab, Pakistan, from September 2025 to January 2026. Seventy-two adults aged 18–65 years were randomized equally to receive either localized rifampicin nanoparticle dressing or conventional antimicrobial dressing for four weeks. Primary outcomes were percentage wound area reduction and quantitative bacterial load. Secondary outcomes included dressing frequency, pain, comfort score, and local adverse effects. Results: Sixty-three participants completed follow-up and were included in the final post-intervention analysis. The rifampicin nanoparticle group showed greater wound area reduction than controls (68.5 ± 12.4% vs 49.2 ± 11.8%; p<0.001) and lower bacterial load (2.1 ± 0.6 vs 3.4 ± 0.7 log CFU/ml; p<0.001). The intervention group also had fewer dressing changes, lower pain scores, and higher comfort scores, while local adverse effects were comparable between groups. Conclusion: Localized rifampicin nanoparticle delivery significantly improved wound healing, bacterial clearance, and patient-centered outcomes in resistant post-surgical wound infections, supporting its potential as an adjunctive wound-care strategy.

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