Ann Dermatol.  2018 Apr;30(2):186-191. 10.5021/ad.2018.30.2.186.

Antibiotic Susceptibility and Treatment Response in Bacterial Skin Infection

Affiliations
  • 1Department of Dermatology, SMG-SNU Boramae Medical Center, Seoul, Korea. hsyoon79@gmail.com

Abstract

BACKGROUND
Bacterial skin infections occur secondarily in conditions involving a vulnerable skin barrier such as atopic eczema, as well as primarily such as impetigo. They are mainly caused by Staphylococcus aureus and Streptococci. Recently, the prevalence of methicillin-resistant S. aureus has been increasing.
OBJECTIVE
To determine the characteristics of community-acquired bacterial skin infections, to observe their antibiotic susceptibility patterns, and to evaluate factors contributing to the treatment response.
METHODS
We retrospectively reviewed outpatients under 30 years old from 2010 to 2015, from whom we had taken skin swabs for antibiotic susceptibility testing. We collected clinical and microbiological characteristics from the medical records.
RESULTS
We evaluated the culture results of 197 patients and reviewed their medical records. Overall, 86.3% (n=170) of the patients responded to the initial treatment regimen. S. aureus was the most commonly isolated pathogen (52.6%) and showed a high resistance rate to penicillin (90.9%) and oxacillin (36.3%). In the multivariable logistic regression analysis, resistance to 3 or more antibiotics (p=0.044), culture amounts described as "many" (p=0.040), and non-systemic antibiotic use (p < 0.001) were significantly associated with lower treatment response. However, methicillin resistance was not associated with lower treatment response both in univariable and multivariable analyses.
CONCLUSION
Among young patients, S. aureus was the most predominant pathogen present in bacterial skin infections. Resistance to high numbers of antibiotics and the use of non-systemic antibiotics were associated with lower treatment response. First-generation cephalosporins may be the most effective first-line empirical regimen for bacterial skin infections treated in outpatient settings, regardless of methicillin resistance.

Keyword

Antibiotic susceptibility; Bacterial skin infection; Infectious skin diseases; Methicillin resistance

MeSH Terms

Anti-Bacterial Agents
Cephalosporins
Dermatitis, Atopic
Humans
Impetigo
Logistic Models
Medical Records
Methicillin Resistance
Outpatients
Oxacillin
Penicillins
Prevalence
Retrospective Studies
Skin Diseases, Infectious
Skin*
Staphylococcus aureus
Anti-Bacterial Agents
Cephalosporins
Oxacillin
Penicillins
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