Skin and skin structure infection
Skin and skin structure infections(SSSIs), also referred to asskin and soft tissue infections(SSTIs),[1]oracute bacterial skin and skin structure infections(ABSSSIs),[2]areinfectionsofskinand associatedsoft tissues(such asloose connective tissueandmucous membranes).[citation needed]Historically, thepathogeninvolved has most frequently been abacterialspecies—always, since redescription of SSSIs as ABSSSIs—and as such, these infections require treatment byantibiotics.[citation needed]
Types[edit]
Until 2008, a distinction was made between two types: complicated SSSIs (cSSSIs) and uncomplicated SSSIs (uSSSIs),[3]which had different regulatory approval requirements.[4][needs update]Uncomplicated SSSIs included "simpleabscesses,impetiginous lesions,furuncles,andcellulitis."[4]Complicated SSSIs included "infections either involving deeper soft tissue or requiring significant surgical intervention, such as infected ulcers, burns, and major abscesses or a significant underlying disease state that complicates the response to treatment."[4]The FDA further noted that "[s]uperficial infections or abscesses in an anatomical site, such as the rectal area, where the risk of anaerobic orGram-negativepathogen involvement is higher, [were also] considered complicated infections. "[4]The uncomplicated category (uSSSI) is most frequently caused byStaphylococcus aureusandStreptococcus pyogenes,whereas the complicated category (cSSSI) might also be caused by a number of other pathogens.[4][verification needed]As of 2013, the pathogen involved in cases of cSSSI were known about 40% of the time.[4][needs update][verification needed]
Diagnosis[edit]
As of 2014, physicians were reported as generally notculturingto identify the infecting bacterial pathogen during diagnosis of SSSIs[5]
Treatment[edit]
Common treatment isempirical,with choice of an antibiotic agent based on presenting symptoms and location, and further followup based ontrial and error.[5][verification needed]To achieve efficacy against SSSIs, physicians most often use broad-spectrum antibiotics,[citation needed]a practice contributing to increasing prevalence ofantibiotic resistance,[citation needed]a trend related to the widespread use of antibiotics in medicine in general.[citation needed]The increased prevalence of antibiotic resistance is evident inMRSAspecies commonly involved in SSSIs, which worsen prognoses and limit treatment options.[citation needed]For less severe infections, microbiologic evaluation using tissue culture has been demonstrated to have high utility in guiding management decisions.[5]
There is no evidence to support or oppose the use of Chinese herbal medicines in treating SSTIs.[6]
See also[edit]
References[edit]
- ^SSTI is the preferred description of theInfectious Diseases Society of America(IDSA), seeStevens, D. L.; Bisno, A. L.; Chambers, H. F.; Dellinger, E. P.; Goldstein, E. J. C.;Gorbach, S. L.;Hirschmann, J. V.; Kaplan, S. L.; Montoya, J. G.; Wade, J. C. (18 June 2014). "Practice Guidelines for the Diagnosis and Management of Skin and Soft Tissue Infections: 2014 Update by the Infectious Diseases Society of America".Clinical Infectious Diseases.59(2): e10–e52.doi:10.1093/cid/ciu296.PMID24947530.
- ^The U.S.Food and Drug Administrationbegan referring to this category of infection as acute bacterial SSSIs (ABSSSI) in 2008. See"Guidance for Industry Acute Bacterial Skin and Skin Structure Infections: Developing Drugs for Treatment"(PDF).Food and Drug Administration.Aug 2010.
- ^Rosen, T (2005). "Update on treating uncomplicated skin and skin structure infections".Journal of Drugs in Dermatology.4(6 Suppl): s9–14.PMID16300224.
- ^abcdef"Guidance for Industry - Acute Bacterial Skin and Skin Structure Infections: Developing Drugs for Treatment"(PDF).Food and Drug Administration. October 2013.Retrieved2014-11-23.
- ^abcXia, Fan Di; Song, Philip; Joyce, Cara; Mostaghimi, Arash (2017)."The Utility of Microbiological Studies in Diagnosis and Management of Suspected Dermatological Infection".JAMA Dermatology.153(11): 1190–1192.doi:10.1001/jamadermatol.2017.3057.PMC5817467.PMID28854298.
- ^Wang, Yun Fei; Que, Hua Fa; Wang, Yong-Jun; Cui, Xue Jun (2014-07-25). Cochrane Wounds Group (ed.)."Chinese herbal medicines for treating skin and soft-tissue infections".Cochrane Database of Systematic Reviews.2014(7): CD010619.doi:10.1002/14651858.CD010619.pub2.PMC8078588.PMID25061914.
Further reading[edit]
- Lee, Su Young; Kuti, Joseph L.; Nicolau, David P. (September 1, 2005)."Antimicrobial Management of Complicated Skin and Skin Structure Infections in the Era of Emerging Resistance".Surgical Infections.6(3): 283–295.doi:10.1089/sur.2005.6.283.PMID16201938– via liebertpub.com (Atypon).