Argenziano Giuseppe, Ardigò Marco, Micali Giuseppe, Nasca Maria Rita, Scilletta Alessandra, Tognetti Linda, Rubegni Pietro, Veraldi Stefano
Clinica Dermatologica, Università della Campania L. Vanvitelli, Napoli.
Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy.
Dermatol Pract Concept. 2024 Oct 30;14(4):e2024282. doi: 10.5826/dpc.1404a282.
Antibiotic resistance has become a serious, severe problem worldwide. This issue does not only relate to the use of systemic antibiotics but to topical ones as well, like systemic therapies and local treatment of skin and mucosal infections. Antiseptics, an alternative to the topical treatment with antibiotics of wounds and some inflammatory dermatological conditions, tend to be microbicidal and have a broader spectrum of antimicrobial activity than antibiotics. Among these, polyhexanide (PHMB) allows for the control of the infection while avoiding the development of resistance.
Recommendations on the rules of good clinical practice for the management of small wounds, burns and post-traumatic ulcerative wounds, impetigo or folliculitis in the initial stages, and acne.
Literature review on the principal topical therapies for small wounds, injuries, impetigo, folliculitis, and acne and a proposal of innovative, highly-tolerated treatments.
Given the abuse of topical antibiotics in dermatology, for the treatment of small wounds, injuries, localized folliculitis, impetigo, and acne, the use of alternative topical treatments like polyhexanide and Rigenase® is recommended.
抗生素耐药性已成为全球范围内一个严重的问题。这个问题不仅与全身用抗生素的使用有关，也与局部用抗生素有关，例如皮肤和黏膜感染的全身治疗和局部治疗。防腐剂作为伤口及一些炎症性皮肤病的抗生素局部治疗的替代方法，往往具有杀菌作用，且抗菌活性谱比抗生素更广。其中，聚己双胍（PHMB）能够控制感染，同时避免耐药性的产生。
针对小伤口、烧伤、创伤后溃疡性伤口、初期脓疱疮或毛囊炎以及痤疮的管理，给出良好临床实践规则的建议。
对小伤口、损伤、脓疱疮、毛囊炎和痤疮的主要局部治疗方法进行文献综述，并提出创新的、耐受性高的治疗方案。
鉴于皮肤科局部用抗生素的滥用，对于小伤口、损伤、局限性毛囊炎、脓疱疮和痤疮的治疗，建议使用聚己双胍和Rigenase®等替代性局部治疗方法。
