Topical Antibacterials and Global Challenges on Resistance Development

Purpose: The skin acts as the first line of defence against the invasion of microorganisms. Damage to the skin such as abrasion, bruises and trauma will expose underlying tissue to bacterial infection. Minor skin infections can be easily treated with topical antibacterial medication that is available over the counter or by prescription. On the other hand, serious bacterial skin infections can be life-threatening and may require complex interventions such as medical or surgical methods to cure the disease. The treatments given have to be assessed according to the presentation, aetiology, chronicity of the wound (depth and size) and/or skin lesions. For skin bacterial infection, topical route of administration is preferred over systemic administration due to the delivery of a higher concentration of medication for the former into the desired area. It is also less likely to cause systemic side effects, toxicity, and bacterial resistance. There is ongoing controversy and debate regarding the likelihood of developing bacterial resistance with the usage of topical antibiotics as an antibacterial. This could be due to inappropriate antibiotic use resulting from self-medication, over the counter availability, prescribing on demand and a lack of regulatory control.

Keywords
Topical antibacterial; Bacterial resistance; Self-medication; Inappropriate antibiotic use; Dispensing