Current and Emerging Topical Antibacterials and Antiseptics: Agents, Action, and Resistance Patterns
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TLDR
A comprehensive understanding of the clinical efficacy and drivers of resistance to topical agents will inform the optimal use of these agents to preserve their activity in the future.Abstract:
Bacterial skin infections represent some of the most common infectious diseases globally. Prevention and treatment of skin infections can involve application of a topical antimicrobial, which may be an antibiotic (such as mupirocin or fusidic acid) or an antiseptic (such as chlorhexidine or alcohol). However, there is limited evidence to support the widespread prophylactic or therapeutic use of topical agents. Challenges involved in the use of topical antimicrobials include increasing rates of bacterial resistance, local hypersensitivity reactions (particularly to older agents, such as bacitracin), and concerns about the indiscriminate use of antiseptics potentially coselecting for antibiotic resistance. We review the evidence for the major clinical uses of topical antibiotics and antiseptics. In addition, we review the mechanisms of action of common topical agents and define the clinical and molecular epidemiology of antimicrobial resistance in these agents. Moreover, we review the potential use of newer and emerging agents, such as retapamulin and ebselen, and discuss the role of antiseptic agents in preventing bacterial skin infections. A comprehensive understanding of the clinical efficacy and drivers of resistance to topical agents will inform the optimal use of these agents to preserve their activity in the future.read more
Citations
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Cosmetics Preservation: A Review on Present Strategies.
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Ozonated Oils as Antimicrobial Systems in Topical Applications. Their Characterization, Current Applications, and Advances in Improved Delivery Techniques.
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References
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Proposed MIC and Disk Diffusion Microbiological Cutoffs and Spectrum of Activity of Retapamulin, a Novel Topical Antimicrobial Agent
TL;DR: Retapamulin had very little activity against 151 gram-negative bacilli and most of the Enterococcus species tested and could be proposed for susceptible, intermediate, and resistant microbiological cutoffs, respectively.
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Hydrogen peroxide vapor room disinfection and hand hygiene improvements reduce Clostridium difficile infection, methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, and extended-spectrum β-lactamase
TL;DR: A statistically significant reduction in Clostridium difficile infection, vancomycin-resistant enterococci, and extended-spectrum β-lactamase-producing gram-negative bacteria is reported associated with the introduction of hydrogen peroxide vapor for terminal decontamination of patient rooms and improvements in hand hygiene compliance.
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Topical iodophor preparations: Chemistry, microbiology, and clinical utility
TL;DR: The background, formulations, chemistry, and microbiology of iodine will be reviewed and recent clinical investigations of utility beyond skin antisepsis will be discussed, potentially lending itself to broader applications than its current uses.
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Skin Commensal Staphylococci May Act as Reservoir for Fusidic Acid Resistance Genes
Wei-Chun Hung,Hsiao-Jan Chen,Yu-Tzu Lin,Jui-Chang Tsai,Chiao-Wei Chen,Hsiao-Hung Lu,Sung-Pin Tseng,Yao-Yu Jheng,Kin Hong Leong,Lee-Jene Teng +9 more
TL;DR: The presence of acquired fusidic acid resistance genes and their genetic environment in commensal staphylococci suggested that the skin commensals staphyllococci may act as reservoir for fUSidic Acid resistance genes.
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Xenoderm Versus 1% Silver Sulfadiazine in Partial-thickness Burns
Seyed Nejat Hosseini,Anayatollah Karimian,Seyed Nouraddin Mousavinasab,Haleh Rahmanpour,Mehdi Yamini,Shokoufeh Hosseini Zahmatkesh +5 more
TL;DR: Xenoderm seems to be more effective than SSD dressing in terms of pain control, degree of wound infection, used wound dressings and length of hospital stay for partial-thickness burns.