Skin and soft-tissue infections: a critical review and the role of telavancin in their treatment

Clin Infect Dis. 2015 Sep 15;61 Suppl 2:S69-78. doi: 10.1093/cid/civ528.

Abstract

Skin and soft-tissue infections (SSTIs) are an important cause of morbidity and mortality among hospitalized patients and a major therapeutic challenge for clinicians. Although uncomplicated SSTIs are managed successfully on an outpatient basis, more serious infections extending to the subcutaneous tissue, fascia, or muscle require complex management. Early diagnosis, selection of appropriate antimicrobials, and timely surgical intervention are key to successful treatment. Surgical-site infections, an important category of SSTI, occur in approximately half a million patients in North America annually. SSTIs are also a potential source for life-threatening bacteremia and metastatic abscesses. Gram-positive organisms, such as Staphylococcus aureus and Streptococcus pyogenes, are the dominant organisms isolated early in the infectious process, whereas gram-negative organisms are found in chronic wounds. Methicillin-resistant S. aureus (MRSA) is a potential bloodstream invader that requires aggressive antimicrobial treatment and surgery. Recent concerns regarding vancomycin activity include heteroresistance in MRSA and increase in the minimum inhibitory concentrations (>1 or 2 µg/mL); however, alternative agents, such as telavancin, daptomycin, linezolid, ceftaroline, dalbavancin, oritavancin, and tedizolid, are now available for the treatment of severe MRSA infections. Here, we present a review of the epidemiology, etiology, and available treatment options for the management of SSTIs.

Keywords: cellulitis; necrotizing infections; skin infections; soft-tissue infections; telavancin.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Aminoglycosides / pharmacology
  • Aminoglycosides / therapeutic use*
  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / therapeutic use*
  • Clinical Trials as Topic
  • Daptomycin / pharmacology
  • Daptomycin / therapeutic use
  • Gram-Negative Bacterial Infections / drug therapy
  • Gram-Negative Bacterial Infections / epidemiology
  • Gram-Negative Bacterial Infections / microbiology
  • Gram-Positive Bacterial Infections / drug therapy
  • Gram-Positive Bacterial Infections / epidemiology
  • Gram-Positive Bacterial Infections / microbiology
  • Humans
  • Lipoglycopeptides
  • Methicillin-Resistant Staphylococcus aureus / drug effects
  • Microbial Sensitivity Tests
  • North America / epidemiology
  • Oxazolidinones / pharmacology
  • Oxazolidinones / therapeutic use
  • Skin Diseases, Bacterial / drug therapy*
  • Skin Diseases, Bacterial / epidemiology
  • Skin Diseases, Bacterial / microbiology
  • Soft Tissue Infections / drug therapy*
  • Soft Tissue Infections / epidemiology
  • Soft Tissue Infections / microbiology
  • Staphylococcal Infections / drug therapy
  • Staphylococcal Infections / epidemiology
  • Staphylococcal Infections / microbiology

Substances

  • Aminoglycosides
  • Anti-Bacterial Agents
  • Lipoglycopeptides
  • Oxazolidinones
  • Daptomycin
  • telavancin