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Antibiotic treatment of cutaneous infections with Staphylococcus aureus in patients with atopic dermatitis: current antimicrobial resistances and susceptibilities.
Exp Dermatol. 2008 Nov; 17(11):953-7.ED

Abstract

BACKGROUND/AIMS

Atopic dermatitis (AD) is a common chronic inflammatory skin disease. In many patients, the disease is complicated by enhanced susceptibility to skin infections, especially with Staphylococcus aureus. The aim of this study was to determine the antimicrobial susceptibility of skin-colonizing S. aureus strains in patients with AD and consecutively to recommend the first-line antibiotic therapy.

METHODS

We studied S. aureus-positive skin swabs (n = 102) from lesional skin of children, adolescents and adults with AD presenting to our inpatient and outpatient departments from January 2005 to June 2006.

RESULTS

Antimicrobial susceptibility testing revealed resistance against oxacillin, amoxicillin/clavulanic acid, cephalexin and cefuroxim in 3%, against tetracycline in 17%, against gentamicin in 16%, against erythromycin and clindamycin in 21%, against trimethoprim/sulfamethoxazol in 23%, against levofloxacin in 23%, against fusidic acid in 25%, against fosfomycin in 12% and against rifampicin in 16%. All strains isolated were susceptible to vancomycin.

CONCLUSION

Currently, the first generation cephalosporin cephalexin appears to be the preferential first-line antibiotic for the treatment of bacterial superinfections with S. aureus in children and adults with AD due to its restricted antimicrobial spectrum to Gram-positive bacteria and a limited number of Gram-negative strains. Cefuroxim and amoxicillin/clavulanate, which also showed 3% resistances in our patients, cover a broader range of bacterial micro-organisms. However, a broader coverage is not required in case of AD, as S. aureus is the most frequent bacterial micro-organism causing skin infections.

Authors+Show Affiliations

Department of Dermatology and Allergology, Hannover Medical School, Hannover, Germany. niebuhr.margarete@mh-hannover.deNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

18557929

Citation

Niebuhr, Margarete, et al. "Antibiotic Treatment of Cutaneous Infections With Staphylococcus Aureus in Patients With Atopic Dermatitis: Current Antimicrobial Resistances and Susceptibilities." Experimental Dermatology, vol. 17, no. 11, 2008, pp. 953-7.
Niebuhr M, Mai U, Kapp A, et al. Antibiotic treatment of cutaneous infections with Staphylococcus aureus in patients with atopic dermatitis: current antimicrobial resistances and susceptibilities. Exp Dermatol. 2008;17(11):953-7.
Niebuhr, M., Mai, U., Kapp, A., & Werfel, T. (2008). Antibiotic treatment of cutaneous infections with Staphylococcus aureus in patients with atopic dermatitis: current antimicrobial resistances and susceptibilities. Experimental Dermatology, 17(11), 953-7. https://doi.org/10.1111/j.1600-0625.2008.00734.x
Niebuhr M, et al. Antibiotic Treatment of Cutaneous Infections With Staphylococcus Aureus in Patients With Atopic Dermatitis: Current Antimicrobial Resistances and Susceptibilities. Exp Dermatol. 2008;17(11):953-7. PubMed PMID: 18557929.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Antibiotic treatment of cutaneous infections with Staphylococcus aureus in patients with atopic dermatitis: current antimicrobial resistances and susceptibilities. AU - Niebuhr,Margarete, AU - Mai,Uwe, AU - Kapp,Alexander, AU - Werfel,Thomas, Y1 - 2008/06/14/ PY - 2008/6/19/pubmed PY - 2009/2/3/medline PY - 2008/6/19/entrez SP - 953 EP - 7 JF - Experimental dermatology JO - Exp Dermatol VL - 17 IS - 11 N2 - BACKGROUND/AIMS: Atopic dermatitis (AD) is a common chronic inflammatory skin disease. In many patients, the disease is complicated by enhanced susceptibility to skin infections, especially with Staphylococcus aureus. The aim of this study was to determine the antimicrobial susceptibility of skin-colonizing S. aureus strains in patients with AD and consecutively to recommend the first-line antibiotic therapy. METHODS: We studied S. aureus-positive skin swabs (n = 102) from lesional skin of children, adolescents and adults with AD presenting to our inpatient and outpatient departments from January 2005 to June 2006. RESULTS: Antimicrobial susceptibility testing revealed resistance against oxacillin, amoxicillin/clavulanic acid, cephalexin and cefuroxim in 3%, against tetracycline in 17%, against gentamicin in 16%, against erythromycin and clindamycin in 21%, against trimethoprim/sulfamethoxazol in 23%, against levofloxacin in 23%, against fusidic acid in 25%, against fosfomycin in 12% and against rifampicin in 16%. All strains isolated were susceptible to vancomycin. CONCLUSION: Currently, the first generation cephalosporin cephalexin appears to be the preferential first-line antibiotic for the treatment of bacterial superinfections with S. aureus in children and adults with AD due to its restricted antimicrobial spectrum to Gram-positive bacteria and a limited number of Gram-negative strains. Cefuroxim and amoxicillin/clavulanate, which also showed 3% resistances in our patients, cover a broader range of bacterial micro-organisms. However, a broader coverage is not required in case of AD, as S. aureus is the most frequent bacterial micro-organism causing skin infections. SN - 1600-0625 UR - https://www.unboundmedicine.com/medline/citation/18557929/Antibiotic_treatment_of_cutaneous_infections_with_Staphylococcus_aureus_in_patients_with_atopic_dermatitis:_current_antimicrobial_resistances_and_susceptibilities_ L2 - https://doi.org/10.1111/j.1600-0625.2008.00734.x DB - PRIME DP - Unbound Medicine ER -