A review of topical therapy for skin infections with bacteria and yeast |
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| Authors: | Mueller Ralf S Bergvall Kerstin Bensignor Emmanuel Bond Ross |
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| Institution: | 1. Small Animal Medicine Clinic, Centre for Clinical Veterinary Medicine, Ludwig Maximilian University, Veterinaerstra?e 13, 80539 Munich, Germany;2. Department of Clinical Sciences, Swedish University of Agricultural Sciences, SLU, PO Box 7040, SE‐750 07 Uppsala, Sweden;3. Dermatology Referral Service, 75003 Paris, 35510 Rennes‐Cesson and 44000 Nantes, France;4. Department of Veterinary Clinical Sciences, Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Herts AL9 7TA, UK |
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| Abstract: | Background – Cutaneous infections with bacteria and yeasts are common in small animal practice. Treatment with systemic antibiotics or antifungal agents may not be ideal, because of the increasing development of multiresistant organisms, the cost and the possible adverse effects. Topical antimicrobials may be used as adjunctive therapy to systemic treatment or as sole therapy instead of systemic treatment. Objective – This literature review evaluated studies on topical antimicrobial treatment of skin infections. Methods – In vitro and in vivo studies evaluating topical antimicrobial agents were identified using a number of electronic and manual searches of textbooks and articles. Studies were evaluated, and the evidence for or against the use of the topical agents was extracted. Results – There is good evidence for the efficacy of chlorhexidine and, to a lesser degree, benzoyl peroxide in canine bacterial skin infections. There is limited evidence for the efficacy of silver sulfadiazine and medical honey against bacterial skin infections in the dog, and for the efficacy of hydrogen peroxide and stannous fluoride in the horse. Good evidence supports the use of a combination of chlorhexidine and miconazole in dogs with cutaneous Malassezia infections. There is insufficient evidence to recommend any other topical therapy for use in cutaneous infections. Conclusions and clinical importance – Although many antimicrobial topicals are marketed in veterinary dermatology, the efficacy has been reported for only a minority of agents. Randomized controlled trials evaluating various topical treatments are therefore urgently needed. |
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