Topical antimicrobial therapy: Current status and challenges.

Area of Science:

• Microbiology
• Pharmacology
• Dermatology

Background:

• Topical antibacterial agents are frequently used, but clinical efficacy data are conflicting.
• While topical application offers advantages like high local concentrations and reduced systemic side effects, challenges remain in monitoring dosage and managing effects on normal bacterial flora.
• The development of drug-resistant bacteria due to unnecessary exposure is a significant concern.

Purpose of the Study:

• To review the clinical utility and pharmacokinetic (PK) aspects of topical antimicrobials.
• To discuss limitations in current antimicrobial susceptibility testing (AST) protocols for topical agents.
• To explore emerging methods for AST tailored to topical applications.

Main Methods:

• Literature review of clinical studies and pharmacokinetic data on topical antimicrobials.
• Analysis of current antimicrobial susceptibility testing (AST) methodologies.
• Exploration of novel approaches for AST in the context of topical drug delivery.

Main Results:

• Topical antimicrobials are established for treating various localized infections, with improving formulations available.
• A significant gap exists in understanding the pharmacokinetics of topical preparations and translating this knowledge into clinical practice.
• Current AST protocols have limitations for evaluating topical agents, necessitating further research into new methods.

Conclusions:

• Further research is needed to bridge the gap between pharmacokinetic knowledge and clinical application of topical antimicrobials.
• Optimizing dosage and duration, alongside developing robust AST methods, is essential for maximizing the benefits of topical antibacterial therapy.
• Understanding the impact on resident microflora and antimicrobial resistance is critical for responsible use.