There are many various soft tissue and skin infections which varies from mild to severe. Determining if the infection only has a local response or has a systemic involvement is an important factor in treating and diagnosing a skin infection.
Topical antibiotics are recognized to be very effective for superficial skin infection treatment like in dermatitis and impetigo. Infected traumatic lesions such as lacerations, abrasions, and suture wounds are also treated by topical antibiotics.
Topical antibiotics are preferred in treating such infections because they are as potent with systemic antibiotics, the systemic toxicity is decreased, decreased bacterial resistance, its antibacterial agent is highly concentrated, and it is versatile.
Examples of Topical Antibiotics:
Skin infections accompanied by hypothermia or fever, hypotension or tachycardia, indicates that further diagnostic test is needed. These tests include drug susceptibility and blood culture, complete blood count, bicarbonate, creatinine, C-reactive protein levels and creatinine phosphokinase. Severe and complicated soft tissue infection indicates necrotizing infection presence and surgical evaluation is needed. These conditions include:
· Pain that is not proportion to physical findings
· Violaceous bullae
· Skin sloughing
· Cutaneous hemorrhage
· Skin anesthesia
· Gas in the tissue
· Rapid progression
Examples of systemic antibiotics for complicated skin infection treatment:
An inhaled Staphylococcus aureus predisposes to infection. Topical antibiotics applied in the nose for nasal carriers prevent infection caused by S. Aureus. The most effective topical agent is Mupirocin for reducing S. aureus carriage.
Topical Treatment Options
The different types of skin infections and different bacterial pathogens need a lot of therapeutic options. Antibacterial topical agents are versatile and extremely important in antimicrobial therapy. These topical agents treat surgical and traumatic wounds, multiple skin infections and for prophylaxis used to prevent infection.
The topical antibacterial agents
· Hydrogen peroxide
Hydrogen peroxide acts by damaging the DNA of the bacteria. It is used in minor wounds and intact skin with limited bacterial activity but it can be harmful for the healing process.
The mechanism of action of chlorhexidine is by disrupting the cytoplasmic membranes of the bacteria. It is often used in hand washes, surgical hand scrubs, and preoperative skin operation. It remains active for a long time after application.
Triclosan’s mechanism of action is by disrupting the bacterial membrane through lipid synthesis blockage. It is used in products such as detergents, soaps, cutting boards and toothpastes. It is resistant to strains of E. coli.
It destroys the mibrobial DNA and protein. To reach full efficacy, it should have two minutes of skin contact. It is usually used in preoperative skin preparation. It is effective against Enterococcus species and MRSA. Adverse reactions are not common but it may cause metabolic acidosis and contact dermatitis in prolonged use.
· Benzoyl Peroxide
It is a broad-spectrum bactericidal. It is used to treat acne vulgaris. It is effective in different kinds of microorganisms which include Staphylococcus capitis, Propionibacterium, avidum, Staphylococcus Epidermidis and Propionibacterium acne.