Clinical implications of antibiotic resistance: risk of systemic infection fromStaphylococcusandStreptococcus

Why Is It That the Biggest Resistance With Fighting the Battle Against Bacterial Resistance Seems to Fall on Dermatology Clinicians?

“…Use of both oral and topical antibiotics creates "ecologic mischief," which is the emergence of less-sensitive strains of other bacteria exposed to the antibiotic-both commensal and opportunistic-especially at anatomic sites such as the skin, nasopharyngeal region, and gastrointestinal and genitourinary tracts. [5][6][7] Application of topical erythromycin to the face can induce erythromycin-resistant bacteria such as staphylococci on the face as well as at remote sites such as the nares (nasal vestibule) and the back. 6 Antibiotics used to treat acne, predominantly oral tetracyclines, showed positive oropharyngeal cultures for Streptococcus pyogenes in 33% (13/39) of treated patients; among these positive cultures, 85% (11/13) were resistant to at least one tetracycline antibiotic.…”

“…[5][6][7] Application of topical erythromycin to the face can induce erythromycin-resistant bacteria such as staphylococci on the face as well as at remote sites such as the nares (nasal vestibule) and the back. 6 Antibiotics used to treat acne, predominantly oral tetracyclines, showed positive oropharyngeal cultures for Streptococcus pyogenes in 33% (13/39) of treated patients; among these positive cultures, 85% (11/13) were resistant to at least one tetracycline antibiotic. 7 Importantly, the streptococcal colonization of the oropharynx in individuals taking an oral antibiotic for acne may not induce a clinically apparent pharyngitis in that individual, but that person can carry and spread that streptococcal pathogen to others.…”