Silver nitrate: antimicrobial activity related to cytotoxicity in cultured human fibroblasts.

The aims of this study were to ascertain whether silver nitrate (AgNO3) concentrations below those used in clinical practice inhibit bacterial growth, and in parallel study the cytotoxic effects on human fibroblasts. The cytoprotective effects of fetal calf serum (FCS) were also evaluated. The cytotoxic effects of eight different silver nitrate concentrations were determined by assessing mitochondrial activity of viable cells capable of cleaving tetrazolium salts. Antimicrobial activity of AgNO3, range: 7-550 x 10(-5)%, was tested against Staphylococcus aureus, Citrobacter freundii, and Pseudomonas aeruginosa. Silver nitrate concentrations exerting antimicrobial effects were: S. aureus, >70 x 10(-5)%; P. aeruginosa, >/=270 x 10(-5)%, and C. freundii, >/=550 x 10(-5)%. With 2% FCS, the lowest AgNO3 concentration studied (7 x 10(-5)%) showed cytotoxic effects (cell survival 71 +/- 19%) at only 2 h of incubation. Under these conditions AgNO3 cytotoxicity was time- and concentration-dependent in all exposure periods. Cytotoxicity was greatly enhanced causing 76% fibroblast growth inhibition at concentrations of 14 x 10(-5)% and contact time of 2 h. The AgNO3 concentration of 7 x 10(-5)% was also cytotoxic with 5% FCS in the media compared with controls, although cell survival was higher than with 2% FCS. The cytoprotective action of FCS was clearly shown at the concentration of 10% at which AgNO3 cytotoxicity of 7 x 10(-5)% to 28 x 10(-5)% was partially or completely inhibited. Our results show that AgNO3 at concentrations 100-700 times more diluted than that normally used in clinical practice retained effective inhibitory activity against some of the above-mentioned microorganisms. However, even these concentrations are cytotoxic for cultured fibroblasts. Thus, silver nitrate concentrations up to 100 times more diluted can be used, since they possess bacterial growth-inhibiting power, are less cytotoxic and therefore favour wound healing.