A review of topical therapy for skin infections with bacteria and yeast.
BACKGROUND
Cutaneous infections with bacteria and yeasts are common in small animal practice. Treatment with systemic antibiotics or antifungal agents may not be ideal, because of the increasing development of multiresistant organisms, the cost and the possible adverse effects. Topical antimicrobials may be used as adjunctive therapy to systemic treatment or as sole therapy instead of systemic treatment.


OBJECTIVE
This literature review evaluated studies on topical antimicrobial treatment of skin infections.


METHODS
In vitro and in vivo studies evaluating topical antimicrobial agents were identified using a number of electronic and manual searches of textbooks and articles. Studies were evaluated, and the evidence for or against the use of the topical agents was extracted.


RESULTS
There is good evidence for the efficacy of chlorhexidine and, to a lesser degree, benzoyl peroxide in canine bacterial skin infections. There is limited evidence for the efficacy of silver sulfadiazine and medical honey against bacterial skin infections in the dog, and for the efficacy of hydrogen peroxide and stannous fluoride in the horse. Good evidence supports the use of a combination of chlorhexidine and miconazole in dogs with cutaneous Malassezia infections. There is insufficient evidence to recommend any other topical therapy for use in cutaneous infections.


CONCLUSIONS
Although many antimicrobial topicals are marketed in veterinary dermatology, the efficacy has been reported for only a minority of agents. Randomized controlled trials evaluating various topical treatments are therefore urgently needed.
Small Animal Medicine Clinic, Centre for Clinical Veterinary Medicine, Ludwig Maximilian University, Veterinaerstraße 13, 80539 Munich, Germany. ralf.mueller@med.vetmed.uni-muenchen.de
Ralf S
RS
Mueller
Kerstin
K
Bergvall
Emmanuel
E
Bensignor
Ross
R
Bond
D000287:Administration, Topical; D000818:Animals; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D000935:Antifungal Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D003881:Dermatomycoses / Q000188:drug therapy / Q000662:veterinary*; D017192:Skin Diseases, Bacterial / Q000188:drug therapy / Q000662:veterinary*; D015003:Yeasts
D000900:Anti-Bacterial Agents; D000935:Antifungal Agents