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Clinical microbiology reviews
07, 2017;30 (3): 827-860.

Current and Emerging Topical Antibacterials and Antiseptics: Agents, Action, and Resistance Patterns.

Deborah A Williamson, Glen P Carter, Benjamin P Howden
Author Information
  1. Deborah A Williamson: Microbiological Diagnostic Unit Public Health Laboratory, Department of Microbiology & Immunology, The University of Melbourne at The Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia deborah.williamson@unimelb.edu.au.
  2. Glen P Carter: Microbiological Diagnostic Unit Public Health Laboratory, Department of Microbiology & Immunology, The University of Melbourne at The Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia.
  3. Benjamin P Howden: Microbiological Diagnostic Unit Public Health Laboratory, Department of Microbiology & Immunology, The University of Melbourne at The Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia.
PMID: 28592405 DOI: 10.1128/CMR.00112-16

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.

Keywords

Staphylococcus aureus antibiotic resistance antiseptic community-acquired infections impetigo skin infections

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MeSH Term

Administration, Topical
Anti-Bacterial Agents
Anti-Infective Agents, Local
Bacteria
Bacterial Infections
Drug Resistance, Bacterial
Humans

Chemicals

Anti-Bacterial Agents
Anti-Infective Agents, Local
Journal Article Review
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