Antimicrobial photodynamic therapy with methylene blue and its derivatives in animal studies: Systematic review

Abstract Background Infections are complications in the wound healing process, and their treatment can lead to antibiotic overuse and bacterial resistance. Antimicrobial photodynamic therapy (aPDT) is used to treat infectious diseases caused by fungi, viruses, or bacteria. Methylene blue (MB) and its derivatives are commonly used dyes in antimicrobial photodynamic therapy (aPDT–MB). Methods This study is a PRISMA systematic review of animal models used to discuss the usefulness and therapeutic parameters of aPDT–MB or its derivatives for treating infected skin wounds. Results After an extensive literature review, 13 controlled trials totaling 261 animals were selected to evaluate skin infection by leishmaniasis and cutaneous bacterial and fungal infections. All studies found results favoring the use of aPDT–MB. Great variability in parameters was found for radiant exposure from 12 to 360 J/cm 2 , MB diluted in saline solution or distilled water, irradiation time from 40 to 3600 s, irradiance most commonly at a maximum of 100 mW/cm 2 , and wavelength used mainly in the 630–670 nm range. Conclusion MB is a safe and promising agent used as a photosensitizer in aPDT for skin‐infected lesions. There is great variability in the parameters found. Comparisons concerning concentration, irradiation time, and light intensity need to be performed.