Over the last few years of clinical practice I've come across the use of acetic acid, i.e. vinegar, for pseudomonas wound infections. When I was in the developing world, and our dressing choice consisted of iodine, hydrogen peroxide, potassium permanganate and gauze, it was one thing that we could use when the telltale bright green with its accompanying odour reared its head.
So I wondered what the evidence was, and came up with this lovely, albeit underpowered, study:
Nagoba, B., Wadher, B., Kulkarni, P. and Kolhe, S. Acetic Acid Treatment of Pseudomonal Wound Infections: Eur J Gen Med 2008;5(2):104-106
accessed at http://www.bioline.org.br/pdf?gm08019
Basically they confirmed what I had picked up in clinical practice, in quite a nice way. They used irrigation and soaked gauze to administer 3% acetic acid in a variety of wounds including 2 foot wounds which had positive cultures for Pseudomonas aeruginosa with varying antibiotic sensitivities and which had failed to respond to usual treatment.
This has since been repeated in different circumstances including in prospective RCTs such as that published by Madhusudhan in 2015 (Int Wound J. 2015 Apr 8. doi: 10.1111/iwj.12428)
So in terms of a low cost treatment for what can be a difficult infection to treat, there is some evidence behind use of vinegar for Pseudomonas.
