Antimicrobial Treatment Strategies for Bacterial Skin Infections

Bacterial skin infections represent a major global health challenge, ranging from superficial impetigo to deeper soft tissue abscesses. Traditional management relies on topical agents—such as fusidic acid, mupirocin and neomycin—for mild to moderate presentations, whereas systemic antibiotics, including beta-lactams and macrolides, are reserved for extensive or complicated cases. Rising antimicrobial resistance has eroded the efficacy of first-line therapies, prompting efforts to optimise dosing regimens, implement combination treatments and develop novel molecules. Among systemic approaches, long-acting lipoglycopeptides have widened the treatment armamentarium by permitting single-dose administration for acute bacterial skin and soft tissue infections. Alternative modalities such as bacteriophage therapy, antimicrobial peptides and photodynamic inactivation are under active investigation, offering non-traditional mechanisms to overcome resistant pathogens. Host-directed strategies, including barrier restoration and immune modulation, seek to complement direct antibacterial activity and reduce recurrence. The integration of rapid diagnostics to guide targeted therapy, alongside stewardship initiatives, aims to preserve antimicrobial utility. Collectively, these multifaceted approaches underscore a shift towards precision in antimicrobial selection, minimisation of off-target effects and the introduction of structurally diverse agents to outpace evolving resistance in skin infections.

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Antimicrobial Treatment Strategies for Bacterial Skin Infections publication trend

The graph below shows the total number of articles in antimicrobial treatment strategies for bacterial skin infections across all publications each year (not limited to Nature Index journals).

Technical terms

Antimicrobial resistance: The ability of microorganisms to survive exposure to drugs that would normally kill them or inhibit their growth.

Topical antibiotic: An antimicrobial agent formulated for direct application to the skin surface to treat localized infections.

Methicillin-resistant Staphylococcus aureus (MRSA): A strain of S. aureus that has acquired resistance to methicillin and related beta-lactam antibiotics.

Impetigo: A common, highly contagious superficial skin infection characterised by pustules and honey-coloured crusts, predominantly affecting children.

Polycyclic polyprenylated acylphloroglucinols (PPAPs): A class of naturally derived compounds with a polycyclic core and prenyl side chains, noted for antimicrobial and anti-inflammatory properties.

References

1. Emergence and spread of a mupirocin-resistant variant of the European epidemic fusidic acid-resistant impetigo clone of Staphylococcus aureus, Belgium, 2013 to 2023. Eurosurveillance (2024).
2. Antimicrobial Evaluation of Two Polycyclic Polyprenylated Acylphloroglucinol Compounds: PPAP23 and PPAP53. International Journal of Molecular Sciences (2024).
3. Topical Antibiotic Treatment in Dermatology. Antibiotics (2023).