A retrospective study determines the characteristics of community-acquired bacterial skin infections, to observe their antibiotic susceptibility patterns, and to evaluate factors contributing to the treatment response. Bacterial skin infections occur secondarily in conditions involving a vulnerable skin barrier such as atopic eczema, as well as primarily such as impetigo. Staphylococcus aureus and Streptococci mainly cause them.

Skin infections are among the most common disorders found in community and hospital environments. These can present in a variety of forms, ranging from limited superficial infections that are controlled by treatment with topical antibiotics to severe infections of deep tissues that can lead to death if the patient is not appropriately treated. 

Staphylococcus aureus and Streptococcus species are the most commonly isolated causative organisms of skin infections; thus, treatment is prescribed empirically to cover these two pathogens. In this retrospective analysis, they examined microbiological characteristics of skin infections and analyzed clinical and microbial factors to predict responses to treatment.

These analyses targeted children and young adults without underlying systemic diseases in an outpatient setting. In this population, the response to initial treatment was high, and even MRSA responded well to empirical antibiotic treatment, including the use of first-generation cephalosporins.

They also found that the number of antibiotic-resistant bacteria, the colony count, and the treatment regimen were associated with responsiveness. In the present study, the overall treatment response was 86.3%. An explanation for this high response was that empirical antibiotics mostly targeted Gram-positive bacteria, which accounted for 96.4% of isolates in this study.

They found that systemic antibiotics were significantly more effective than topical antibiotics for skin infections. Since patients with mild and limited localized infections were more likely to choose topical treatment, oral antibiotics are more likely to be useful than topical antibiotics under the same disease severity conditions.

In the present study, the treatment response of MRSA to empirical antibiotic use was more than 80%. It has been reported that therapeutic response is obtained when appropriate drainage is combined with empirical systemic antibiotics, even without the use of intravenous agents such as vancomycin, which is currently recommended.

Antibiotic-resistance testing is recommended. In the Previous studies, this drug may be suitable as a second-line option when first-generation cephalosporin treatment fails. However, because serious side effects such as rashes, allergic reactions, or bone marrow suppression are not rare, TMP-SMX is still recommended as a second-line treatment.