Treatment Overview
There are many different skin and soft tissue infections, which can vary from mild to severe. The most important factor in diagnosing and treating a skin infection is determining whether there is only a local response or if there is systemic involvement.
Topical Antibiotics
Topical antibiotics are considered to be extremely effective in treating a host of superficial skin infections, such as impetigo and dermatitis. They are also used to treat secondarily infected traumatic lesions, such as suture wounds, lacerations and abrasions.
Decreased systemic toxicity, decreased bacterial resistance, versatility and a high concentration of antibacterial agent at the infection site frequently make topical antibiotics a preferred and equally effective treatment to systemic antibiotics.
Examples of topical antibiotics include:
- Mupirocin
- Neomycin
- Polymyxin
- Bacitracin
Systemic Antibiotics
A skin infection that is accompanied by fever or hypothermia, tachycardia or hypotension indicates the need for further diagnostics tests. These typically include blood culture and drug susceptibility; complete blood cell count; creatinine, bicarbonate, creatine phosphokinase, and C-reactive protein levels. Additional physical clues to complicated, severe soft tissue infection may indicate the presence of a necrotizing infection and the need for surgical evaluation. These include:
- Pain disproportionate to physical findings
- Violaceous bullae
- Cutaneous hemorrhage
- Skin sloughing
- Skin anesthesia
- Rapid progression
- Gas in the tissue
Examples of systemic antibiotics used to treat complicated skin infections include:
- Penicillin
- Clindamycin
- Dicloxacillin
- Cephalexin
- Doxycycline
- Minocycline
- Trimethoprim-sulfamethoxazole
- Vancomycin
Prophylactic Antibiotics
Nasal carriage of Staphylococcus aureus predisposes the carrier to infections. In order to prevent S aureus infections, topical antibiotic may be applied to the nares of carriers. Mupirocin is currently the most effective topical antibiotic for reducing carriage of S aureus.
