Antibacterial treatment of skin infections

Human has a special structure of the skin. Various factors, both external and internal, affect organ. They are responsible for the unpleasant diseases. Many of the skin infections are the impact of factors such as parasites, viruses, microscopic fungi, and bacteria. Most often, the pathogenic agent gets on the skin and deep soft tissues due to injuries. It doesn’t have to be a big wound. It’s enough only micro damages in order to bacteria and microbes penetrated into the cells and start the process of changing the body, infecting it. Infections of the skin and soft tissue are common worldwide. People of different age groups suffer from them. Bacterial skin infections can manifest not only in adults, but also in children. Only a competent specialist can find the differences between non-communicable and infectious diseases.


Table of contents:

  1. What bacteria cause skin infections?
  2. Features of primary skin disorders
  3. What causes secondary diseases?
  4. Treatment of mild and moderate severity infections
  5. Factors affecting the choice of therapy
  6. Features of drugs for local treatment
  7. Useful links

Skin infections of mild or moderate severity – a pathology, which is observed quite often. About 10 million people in the US annually go to the emergency department with traumatic soft tissue injuries of varying severity. The most common complication in these cases is a bacterial disease. Since the 1960s, doctors began using oral antibiotics to treat skin infections. Oral therapy is combined sometimes with topical preparations.

It should be noted that the type of skin disease depends on the agent of infection. Bacteria cause the most dangerous skin disorders. This occurs when bacteria enter the body through a break in the skin, such as a cut or a scratch. Getting a cut or scratch doesn’t necessarily mean you’ll develop a skin infection, but it does increase your risk if you have a weakened immune system. A decreased immune system can be the result of an illness or the side effect of medication [1].

What bacteria cause skin infections?

What bacteria cause skin infections

Pathogenic and conditionally pathogenic agents, most of which are streptococci and staphylococcus, cause a number of skin diseases. Nowadays, skin infections caused by a combination of these pathogens are quite common. In addition, proteus, pneumococci, and Pseudomonas aeruginosa can cause inflammation of the skin, developing into dangerous infections.

The pathogenesis of skin infections is simple and differs little from diseases caused by other microorganisms. These pathogens are widespread in the environment. The person is constantly in contact with them. Protective factors of healthy skin allow human to fight pathogens without causing inflammation on the skin. In case of violation of the integrity of the skin, reduction of immune factors and a number of other pathological processes in the body, the pathogen, which penetrates the skin, causes an infectious process.

Specialists classify skin infections by etiology (staphylo – streptococci), by the depth of the skin lesion, by the duration of the disease (acute or chronic infection) and by the phasing of the process (primary or secondary disorder).

Clinically staphylo-and streptococcal skin infection is presented in the form of pustules. However, they have a number of external differences. Staphylococcus pustule occurs in any place where there is hair. It’s filled with purulent contents and has a conical shape with a cavity in the center. The surface of the pustules is intense. The entire inflammatory process spreads deep into the tissues. Streptococcal skin infection is localized around the natural openings (mouth, nose) in the form of pustule with a loose surface. The skin infection process spreads over the surface of the adjacent tissues, forming yellow crusts.

The most common forms of skin infection:

  • folliculitis
  • furuncle
  • carbuncle and others

Skin treatment for bacterial skin infections consists of properly selected antibiotic therapy. Doctor appointment it individually, depending on the etiology of the disease, age, the severity of the infectious process and the presence of complications. In addition, proper skin care is necessary for the speedy onset of improvements. Most often, doctors use a complex method of treatment using antibiotics, both oral and topical. Amoxicillin, Keflex and Zithromax are the most popular drugs of the first group. Furacin and Mupirocin are the most popular topical medications. Doctors recommend them due to high effectiveness and the absence of side effects.

A surgeon carries out the treatment in a hospital if the purulent process is localized on the face. Children also need urgent hospitalization. Parents in any case should not hold the treatment of skin infections at home.

Features of primary skin disorders

Primary skin infections are those diseases, in which the skin, surrounding the site of infection, is intact. Pathogenic microorganisms, in most cases causing the development of primary skin infections, including Staphylococcus aureus and Streptococcus group A (Str. Pyogenes).

Impetigo, folliculitis, cellulitis, and furunculosis are the most common primary skin infections. Impetigo is characterized by the presence of blister-type rash elements, which, form deep erosion by rupture. Friable crusts of light yellow color are formed when drying erosion. Previously, experts believed that contagious impetigo has streptococcal etiology, and Staphylococcus aureus causes the development of bullous impetigo. The results of many modern clinical studies indicate a change in the prevalence of these pathogens of skin infection. Today Staphylococcus aureus is the main causative agent of infectious impetigo. According to some authors, in 77-98% of cases, the development of impetigo is caused by staphylococci, in 3% of cases only streptococci. It should be noted that studies were conducted among people living in countries with a developed economy and a relatively high standard of living. At the same time, Streptococcus pyogenes is the most frequent causative agent of contagious impetigo in countries with a tropical climate and low living standards.

What causes secondary diseases?

Secondary skin infections develop in those places where the skin at the site of the infection has been already damaged. As an example, doctors call secondarily infected traumatic skin lesions and secondarily infected dermatosis.

Skin lesions such as cuts, burns, wounds, including surgical, are reasons for secondary skin infections. Such diseases are caused by infection with streptococci and staphylococci in 80-90% of cases. Secondarily infected dermatoses develop as a result of superinfection of an existing pathological process, such as eczema. Damaged skin is the entrance gate for the causative agents. The subsequent invasion and reproduction of bacteria lead to the development of skin infection. Staphylococcus aureus and streptococci cause most often the development of a secondarily infected dermatosis. Experts suggest that staphylococcus is not only the main etiological cause of eczema but also contribute to the occurrence of relapses of the disease. In addition, these bacteria worsen the course of an existing pathological process.

Treatment of mild and moderate severity infections

Since the 1960s, the use of antibiotics for oral administration has been the focus of treatment for mild to moderate skin infections. Doctors apply modern preparations containing erythromycin, cephalexin, and flucloxacillin in most countries.topical antibiotic drug

Despite the fact that oral antibiotic therapy is effective in many cases, it’s not without drawbacks. Oral antibiotics, due to their systemic activity, often cause the development of adverse reactions from the digestive tract (for example, diarrhea or nausea). An important condition for maintaining an appropriate concentration of the antibiotic in the blood is its regular and frequent use. Any violation of the mode of administration or dosing of the drug can significantly affect its effectiveness. Treatment of skin infection with antibiotics can develop allergic reactions by systemic using.

Another disadvantage of antibiotic treatment, used orally, is the rapid development of pathogens resistance to drugs. For example, the sustainability of Staphylococcus aureus, due to the use of lactam antibiotics, is quite common. According to research, its level in the world reaches 90%. About 10 years ago, Staphylococcus aureus sensitivity to erythromycin reached no more than 30%. The observation, which studied the course of various skin infections, showed that 51.5% of these bacteria, detected during bacteriological examination of pus with furunculosis, were resistant to erythromycin. This figure reached 26.2% for impetigo.

Doctors use some antibiotics to treat hospital-acquired skin infections. It leads to the development of pathogens resistant to these drugs too. Currently, many experts do not recommend prescribing antibiotics for local therapy, which include components that have a systemic effect. According to recent studies, the resistance of pathogens develops as a result of the use of aminoglycosides, erythromycin, and clindamycin for local using.

However, it’s necessary to establish the correct diagnosis before starting treatment. To diagnose a skin infection, health care providers will do a physical exam and ask about your symptoms. You may have lab tests, such as a skin culture. This is a test to identify what type of infection you have, using a sample from your skin. Your provider may take the sample by swabbing or scraping your skin, or removing a small piece of skin (biopsy). Sometimes providers use other tests, such as blood tests [2].

Factors affecting the choice of therapy

The choice of local or oral antibiotic therapy for skin infections depends on many factors. However, the localization and prevalence of the infectious process are decisive. Local therapy is effective if the infection process is superficial and localized. If the pathological process reaches deeper structures of the skin or a large area is affected, antibiotics can be used for oral administration. If there is a manifestation of a systemic infection, such as fever, lymphadenopathy, or concomitant streptococcal pharyngitis, then doctors prescribe oral antibiotics. In some cases, the doctor may prescribe both local and systemic antibiotic therapy for a patient with a common skin infection or with a severe course of the infectious process.

The results of many clinical studies have not confirmed the assumption that in the treatment of mild to moderate skin infections, local therapy is less effective than oral medication. For example, researchers have proven that in mild to moderate skin infections, monotherapy with mupirocin in the form of a cream or ointment is very effective. This treatment in some cases exceeds the effectiveness of therapy with erythromycin, cloxacillin, and cephalexin, administered orally. Drugs for topical administration are convenient to use, they are easier to dose than oral medications. Many patients would prefer local therapy, having the possibility of choosing a method of treatment.

When conducting local therapy for skin infection, the risk of systemic side effects, including from the digestive tract, is minimal. The antibiotic affects the microflora of the digestive tract with orally taking. This often leads to the emergence of resistant to the action of the drug strains of microorganisms that inhabit the digestive tract. In addition, a higher concentration of the antibiotic, which is used at the site of skin infection, contributes to the eradication of a larger number of pathogenic microorganisms.

Features of drugs for local treatment

Antibacterial drugs for local use must meet the following requirements:

  • medications must be as effective as oral medications
  • drugs must be well tolerated
  • they must be active against all major pathogens causing mild to moderate skin infections
  • drugs should be produced in dosage forms suitable for use in both primary and secondary skin infections

Antibacterial drugs for local use should not comply with the following provisions:

  • medicines should not cause cross-resistance to other similar antibiotics that patient use to treat skin infections
  • drugs should not contain components that have a systemic effect

Experts recommend that patients use a healing ointment in the final stages of treatment. Such a remedy eliminates all damage caused by an infectious lesion. The attending physician is engaged in its selection.

If the skin infection is completely defeated, the doctor chooses a natural cream. There are many healing medicines. Many of them help recover the skin in the shortest possible time.

Useful links


[1] Read more facts about causes of skin infections by the link https://www.healthline.com/health/skin-infection#causes


[2] Learn detailed information about skin infections on the resource https://medlineplus.gov/skininfections.html

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