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The Role of Topical Antibiotics in Dermatologic Practice

  • Authors: Author: J.J. Leyden, MD
    Medical Writer: Linda Mattucci Schiavone
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Target Audience and Goal Statement

This activity is intended for physicians and nurses.

The goal of this activity is to describe the use of topical antibiotics in dermatologic practice, including the organisms involved in these infections, issues of emerging antibiotic resistance, and the uses, advantages, and potential limitations of such therapy.

Upon completion of this activity, participants will be able to:

  1. List the most common organisms involved in cutaneous bacterial infections, both hospital-acquired and community-acquired.
  2. Describe the benefits of occlusion in wound healing.
  3. List and discuss the advantages and disadvantages of the common topical antibacterial agents used for the treatment of superficial cutaneous bacterial infections in dermatologic practice.
  4. Discuss the issue of neomycin use and contact dermatitis.

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    For Physicians

  • Medscape, LLC is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

    Medscape designates this educational activity for a maximum of 1 category 1 credit(s) toward the AMA Physician's Recognition Award. Each physician should claim only those credits that he/she actually spent in the activity.

    The American Medical Association has determined that non-US licensed physicians who participate in this CME activity are eligible for AMA PRA category 1 credit.

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    For Nurses

  • 1.2 contact hours of continuing education for RNs, LPNs, LVNs, and NPs. This activity is cosponsored with Medical Education Collaborative, Inc. (MEC) and Medscape. MEC is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.
    Board of Nursing, Provider Number FBN 2773.
    California Board of Registered Nursing, Provider Number CEP 12990, for 1.2 contact hours.

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The Role of Topical Antibiotics in Dermatologic Practice

Authors: Author: J.J. Leyden, MD Medical Writer: Linda Mattucci SchiavoneFaculty and Disclosures


The Skin and Infection

Normal, healthy skin presents a natural physical barrier to bacterial invasion. An intact stratum corneum layer provides a barrier to a wide variety of bacteria and other pathogens. The natural resistance of the skin to bacterial penetration and multiplication is not completely understood, but elements involved include the following factors[1]:

  • Inability of organisms to penetrate the keratinized stratum corneum;
  • Desquamation, which sheds bacteria as it sloughs keratinocytes;
  • Natural acidity of the skin (pH 5.5);
  • Presence of antibacterial substances in sebaceous secretions and intracellular lipids of the stratum corneum;
  • Relatively low moisture content of skin; and
  • Normal cutaneous microflora.

Changes in any of these factors can greatly influence an individual's susceptibility to infection, as can changes in the overall ability of the host to mount an inflammatory response. Nonpathogenic microbes are capable of becoming disease-producing pathogens in individuals with reduced cellular or humoral defenses or defects (eg, immunocompromised or nutritionally compromised individuals).