![]() ![]() As an antimicrobial and anti-inflammatory agent, it is used in the treatment of acne and rosacea. It is available as a 15%–20% cream and gel and used twice daily. Azelaic acid is bacteriostatic against staphylococci, Propionibacterium, and some gram-negative organisms. ![]() The precise mechanism of its antibacterial activity is not clear it may act by inhibition of bacterial protein synthesis. ![]() Topical antibacterials may also benefit some non-infective conditions such as rosacea, Grover's disease, plasma cell balanitis and gingivitis, and confluent and reticulated papillomatosis.Īzelaic acid is a naturally occurring nine-carbon dicarboxylic acid having antibacterial, anti-inflammatory, and comedolytic properties. Some agents such as benzoyl peroxide (BPO) and clindamycin are almost exclusively used for the treatment of acne. One of the major indications of topical antibacterials is acne vulgaris. Additionally, topical antiseptics are universally used for hand hygiene and preoperative surgical scrubbing. Prophylactic topical therapy is often used for burns to prevent the complication of serious secondary infections. However, topical antibacterials do not appear to aid healing or prevent infections of clean wounds made during minor surgery. Topical antibiotics are at times used following minor surgical procedures. Intranasal topical antibiotics are also indicated for the elimination of staphylococcal carrier state. Topical antibiotics are used in the treatment of secondary bacterial infections of skin disorders like eczema and leg ulcers. Other pyodermas, such as carbuncles, ecthyma, cellulitis, or erysipelas, are best treated with appropriate systemic antibiotics. Topical antibiotics are widely used for the treatment of folliculitides and furuncles, but their action may be very modest and limited to avoid the spreading of the infection from the primary lesion to the adjacent follicles. Topical antibacterials are commonly used for superficial pyodermas such as impetigo and treatment or prevention of infections following minor cuts, abrasions, burns, and surgical wounds. Additionally, acne vulgaris, whose pathogenesis involves bacterial infection, is also treated with topical antibacterials. Topical antibacterials are commonly used for the prevention and treatment of skin infections. ![]() Gram-negative organisms such as enteric bacilli (mainly Pseudomonas aeruginosa) are sometimes involved in cutaneous infections, particularly in the groin and the ear, foot ulcers, and intertriginous infections. Staphylococcus aureus and group A Streptococci are the two most frequently encountered pathogens causing primary and secondary infections of the skin and minor skin wounds. Thus, physical traumas in the form of abrasions, penetrations, cuts and burns, pre-existing dermatoses with impaired barrier states, undernutrition, diabetes mellitus, and various congenital and acquired immunodeficiency syndromes can all lead to cutaneous bacterial infections. Impairment of this barrier may make an individual susceptible to infection. Normal, healthy skin offers a formidable natural barrier to invasion by pathogens. Although many botanical products have demonstrated in vitro activities against skin pathogens, their clinical utilities remain to be established by good-quality clinical trials. Incidence of contact dermatitis is a limiting factor for the use of several topical antibacterials. Bacterial resistance to topical antibiotics is a growing concern and topical antiseptics such as gentian violet are getting renewed interest as alternatives. Mupirocin and fusidic acid are the two most commonly used antibiotics for the treatment of superficial pyodermas and eradication of staphylococcal carrier state. One of the major uses of topical antibacterials is acne in which benzoyl peroxide is the drug of the first choice either singly or in combination with antibiotics or retinoids. Several antibiotics and antiseptics are available for use in different indications. ![]()
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