Skin Infections

Question 1

Mupirocin (Bactroban)

Answer 1

Antimicrobials for Skin Infections
- antibacterial agent produced by fermentation using the organism Pseudomonas fluorescens.
• Nasal application to eradicate carriage state with MRSA; AKA “*decolonization” may also require disinfecting wash of skin & systemic Abx
INDICATIONS
- *topical treatment of impetigo due to: S. aureus and S. progenies.
- *Gr+ bacteria including MRSA.
- active against certain Gr- bacteria.

Question 2

Silver sulfadiazine

Answer 2

Antimicrobials for Skin Infections
- antimicrobial properties are derived from the dual mechanisms of its silver and sulfa moieties
INDICATIONS
- most commonly used topical antimicrobial agent in *burns
- broad spectrum of antimicrobial coverage including Gr+ bacteria, most Gr- bacteria, and some yeast forms.

Question 3

Bacitracin

Answer 3

Antimicrobials for Skin Infections
INDICATIONS
- *Gr+ bacteria
MOA
- inhibits the function of a lipid transport molecule in bacteria which carries the building blocks of the peptidoglycan bacterial cell wall outside the cell membrane for construction. 
ADE
- contact dermatitis 
o nephrotoxicity

Question 4

Polymixin B, Colistin (Polymixin E)

Answer 4

Antimicrobials for Skin Infections
INDICATIONS
- Gr- bacteria
MOA
- interact electrostatically with the outer membrane (like soap) of Gr- bacteria and competitively displace divalent cations from the membrane lipids, specifically calcium and magnesium
- This disrupts the outer membrane and changes its permeability
- end result is leakage of cell content, cell lysis and death.
ADE
• Nephro- and Neuro-Toxic

Question 5

Terbinafine

Answer 5

Antimicrobials for Skin Infections
Allylamine antifungal
INDICATIONS
- Fingernail or Toenail Fungal Infections (ie. Tinea unguium)
MOA
- inhibits biosynthesis of ergosterol (essential component of fungal cell membrane)
- via inhibition of squalene epoxidase enzyme.
- This results in fungal cell death primarily due to the increased membrane permeability
ADE
- **Hepatoxocity
- taste and smell disturbances
- depression
-hematological effects
- skin rx
- SLE