Antimicrobial therapy for skin infections.
1VA Puget Sound Health Care System, Seattle, Washington, USA.
Cutis
|July 26, 2007
Summary
Common skin infections from Staphylococcus aureus or streptococci require specific oral antibiotics. However, conditions like furuncles and abscesses primarily need incision and drainage, not antibiotics, unless severe infection is evident.
Area of Science:
- Dermatology
- Infectious Diseases
- Microbiology
Background:
- Common skin infections are frequently caused by Staphylococcus aureus, group A streptococci (Streptococcus pyogenes), or the skin's normal flora.
- Effective treatment strategies vary significantly based on the specific type of skin infection.
- Understanding the causative agents is crucial for appropriate therapeutic interventions.
Purpose of the Study:
- To outline the preferred treatment modalities for common bacterial skin infections.
- To differentiate between conditions requiring antimicrobial therapy and those managed by drainage.
- To clarify the role of systemic antibiotics in specific dermatological conditions like impetigo and cellulitis.
Main Methods:
- Review of established clinical guidelines and literature on bacterial skin infections.
- Analysis of treatment approaches for impetigo, cellulitis, furuncles, carbuncles, cutaneous abscesses, and inflamed epidermal cysts.
- Evaluation of the necessity of antimicrobial therapy in non-infected or minimally infected conditions such as venous ulcers and atopic eczema.
Main Results:
- Antistaphylococcal oral antibiotics are recommended for nonbullous and bullous impetigo.
- Broad-spectrum oral antibiotics effective against both S. aureus and streptococci are suitable for most cellulitis cases.
- Incision and drainage are the primary treatments for furuncles, carbuncles, cutaneous abscesses, and inflamed epidermal cysts, often negating the need for antibiotics.
- Systemic antimicrobial therapy offers no benefit for patients with venous ulcers and atopic eczema unless clear signs of infection (fever, cellulitis, lymphangitis) are present.
Conclusions:
- Treatment for bacterial skin infections should be tailored to the specific diagnosis and causative organism.
- Incision and drainage are paramount for purulent skin infections, with antibiotics reserved for specific indications.
- Systemic antibiotics are not routinely beneficial for non-infected chronic skin conditions like eczema or ulcers.
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