Porras-Luque J I
Dermatólogo, Centro Médico Conde de Orgaz, Madrid, España.
Actas Dermosifiliogr. 2007 Sep;98 Suppl 1:29-39. doi: 10.1016/s0001-7310(07)70179-5.
Topical antimicrobial agents are chemical substances that, directly applied to the skin, inhibit the growth or destroy any microorganism, either fungi, viruses or bacteria. Within this term, we generally refer to those that are active against the latter. They are divided into antiseptics and antibiotics. Antiseptics are directly applied to a living organism to eradicate the existing microorganism on the mucocutaneous surfaces, preventing their proliferation. Topical antibiotics are either produced by living organisms or manufactured through synthesis and are mainly used to fight infections. Topical antimicrobials represent an important option in the prophylaxis and treatment of primary and secondary superficial bacterial infections. Antibiotics for topical use have a lower incidence of systemic toxicity, secondary effects and development of resistance than parenteral antibiotics. The ideal topical antimicrobial must have a broad spectrum of activity, fast and prolonged antibacterial effect, bactericidal activity, easy diffusion through tissues and detritus, with minimal toxicity, very low or null incidence of irritation or allergy and sparse activity against normal skin flora. The approach of this article is the description of the classical and new antimicrobials that are, more important due to their wide use and proven efficacy. We review their pharmacological characteristics, spectrum of activity, possible secondary effects and interactions, as well as the combinations that improve their antimicrobial activity, main indications and possible development of resistance, all this properly documented.
局部用抗菌剂是直接应用于皮肤的化学物质，可抑制或杀灭任何微生物，包括真菌、病毒或细菌。在此术语范围内，我们通常指那些对细菌有效的抗菌剂。它们分为防腐剂和抗生素。防腐剂直接应用于生物体，以根除粘膜皮肤表面现有的微生物，防止其增殖。局部用抗生素要么由生物体产生，要么通过合成制造，主要用于对抗感染。局部用抗菌剂是预防和治疗原发性和继发性浅表细菌感染的重要选择。与注射用抗生素相比，局部用抗生素的全身毒性、副作用和耐药性发生率较低。理想的局部用抗菌剂必须具有广谱活性、快速且持久的抗菌作用、杀菌活性、易于通过组织和碎屑扩散、毒性最小、刺激或过敏发生率极低或无、对正常皮肤菌群活性微弱。本文的方法是描述经典和新型抗菌剂，由于它们广泛使用且疗效已得到证实，因而更为重要。我们回顾它们的药理学特性、活性谱、可能的副作用和相互作用，以及提高其抗菌活性的组合、主要适应症和可能的耐药性发展，所有这些都有充分的文献记载。
