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Silver ion (Ag+) is the biologically active form of elemental silver and is responsible for the antimicrobial properties attributed to various medical and consumer products containing silver. Silver ions are released from metallic or compound forms of silver in the presence of water, body fluids, or tissue exudates. They exhibit broad-spectrum antimicrobial activity by disrupting bacterial, fungal, and protozoal cell membranes through binding to disulfide groups in membrane proteins and peptidoglycans. This leads to loss of membrane integrity and function. Silver ions also bind to sulfhydryl groups in cytoplasmic enzymes, inhibiting metabolic processes; they can increase reactive oxygen species within microbial cells causing oxidative stress; modulate cellular signaling by inhibiting phosphorylation of essential proteins; and attach to guanine in DNA, thereby inhibiting replication[4][5][6]. In medicine, ionic silver has been used topically for wound care (e.g., burns), as an antiseptic (notably as silver nitrate), incorporated into medical devices for infection prophylaxis (e.g., catheters), ophthalmic preparations for eye infections or post-surgical care[3][5][6]. Despite its historical use as an anti-infective agent before antibiotics were available, systemic use is not approved due to potential toxicity such as argyria with chronic exposure[7].
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