Abstract
Skin and soft tissue infections (SSTIs) are a major therapeutic challenge for clinicians. The emergence of pathogens with decreased susceptibility to available therapies has become an emerging problem often associated with treatment failure. Hence, there is an urgent need for novel broad-spectrum antimicrobial agents. The purpose of this study was to assess the feasibility of chlorquinaldol as an alternative approach to currently used topical antibiotics for the treatment of skin and soft tissue infections. The activity of chlorquinaldol was investigated against a collection of bacterial isolates responsible for skin infections, including strains resistant to fusidic acid and gentamicin. After determination of MIC and MBC, time-kill experiments were carried out by counting colonies grown after 0, 3, 6, 9, 24, and 48 h of incubation with concentrations equal to ¼×, ½×, 1×, 2×, and 4× MIC of chlorquinaldol, gentamicin, or fusidic acid. Staphylococci resulted the Gram-positives most sensitive to chlorquinaldol, with MIC-values ranging from 0.016 to 0.5 mg/L. A lower activity was observed against Gram-negative bacteria, with 77% of the isolates being inhibited at concentrations ranging from 128 to 512 mg/L. Generally, in time-kill studies, chlorquinaldol showed a bactericidal activity at the higher concentrations (2×, 4× MIC) after 24–48 h of incubation. In conclusion, chlorquinaldol may represent a valuable alternative to conventional topical antibiotics for the treatment of skin and soft tissue infections.
Highlights
Skin and soft tissue infections (SSTIs) are commonly occurring diseases with a wide-range of clinical manifestations varying from minor superficial to life-threatening infections (Ray et al., 2013)
Relevant strains isolated from SSTIs at the Laboratory of IRCCS Galeazzi Orthopedic Institute were used
Chlorquinaldol spectrum of activity revealed a lower activity against Gram-negative bacilli in respect to the Gram-positive tested bacteria, with 77% of the isolates being inhibited at concentrations ranging from 128 to 512 mg/L and 23% being inhibited at concentrations ≤32 mg/L
Summary
Skin and soft tissue infections (SSTIs) are commonly occurring diseases with a wide-range of clinical manifestations varying from minor superficial to life-threatening infections (Ray et al., 2013). They may range from “simple uncomplicated” infections, such as erysipelas, cellulitis, simple abscesses, furuncles, and wound infections, to deeper “complicated” infections, such as necrotizing fasciitis, myositis, and gas gangrene. Even though careful attention is paid to patients with acute infections, treatment often fails in chronic ones, where healing is hampered by the presence of bacterial biofilm (Bjarnsholt, 2013).
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