Department of Internal Medicine, Division of Infectious Diseases, Tufts Medical Center, Boston, Massachusetts.
Clin Infect Dis. 2019 Apr 8;68(Suppl 3):S206-S212. doi: 10.1093/cid/ciz004.
Acute bacterial skin and skin-structure infections (ABSSSIs) are a common reason for seeking care at acute healthcare facilities, including emergency departments. Staphylococcus aureus is the most common organism associated with these infections, and the emergence of community-associated methicillin-resistant Staphylococcus aureus (MRSA) has represented a considerable challenge in their treatment. To address this need, a number of new antibiotics have been developed for the treatment of ABSSSIs in the past several years. Most of these agents focus primarily on gram-positive organisms, particularly MRSA; however, there has not been an oral agent that can reliably treat MRSA, as well as relevant gram-negative pathogens. Acute skin infections that involve mixed gram-positive and gram-negative pathogens must also be considered as they can be associated with discordant antimicrobial therapy. Here, I review ABSSSI treatment guidelines in the hospital setting and discuss current and future antibiotic options for treatment of this commonly encountered infection.
急性细菌性皮肤和皮肤结构感染(ABSSSI)是在急性医疗机构(包括急诊科)寻求治疗的常见原因。金黄色葡萄球菌是与这些感染最相关的最常见病原体,而社区获得性耐甲氧西林金黄色葡萄球菌(MRSA)的出现给其治疗带来了巨大的挑战。为了应对这一需求,在过去几年中已经开发出许多新的抗生素来治疗 ABSSSI。这些药物中的大多数主要针对革兰氏阳性菌,尤其是 MRSA;然而,目前还没有一种口服药物可以可靠地治疗 MRSA 以及相关的革兰氏阴性病原体。还必须考虑涉及混合革兰氏阳性和革兰氏阴性病原体的急性皮肤感染,因为它们可能与不和谐的抗菌治疗有关。在这里,我回顾了医院环境中的 ABSSSI 治疗指南,并讨论了目前和未来用于治疗这种常见感染的抗生素选择。