Abstract
Acute bacterial skin and soft tissue infections (aSSTIs) are a large group of diseases that can involve exclusively the skin or also the underlying subcutaneous tissues, fascia, or muscles. Despite differences in the localization and severity, all these diseases are due mainly to Gram-positive bacteria, especially Staphylococcus aureus and Streptococcus pyogenes. aSSTI incidence increased considerably in the early years of this century due to the emergence and diffusion of community-acquired methicillin-resistant S. aureus (CA-MRSA). Despite the availability of antibiotics effective against CA-MRSA, problems of resistance to these drugs and risks of significant adverse events have emerged. In this paper, the present knowledge on the potential role new antibiotics for the treatment of pediatric aSSTIs is discussed. The most recent molecules that have been licensed for the treatment of aSSTIs include ozenoxacin (OZ), ceftaroline fosamil (CF), dalbavancin (DA), oritavancin (OR), tedizolid (TD), delafloxacin (DL), and omadacycline (OM). However, only OZ and CF have been licensed for use in children with aSSTIs, although the superiority of these antibiotics to those routinely used for the treatment of aSSTIs should be further demonstrated. Waiting for additional studies, OZ and CF should be prescribed for aSSTI treatment in the presence of the potential failure of old molecules.
Highlights
Acute bacterial skin and soft tissue infections are a large group of diseases that can involve exclusively the skin, such as in the case of impetigo, or have a deeper localization, with the involvement of the underlying subcutaneous tissues, fascia, or muscles, causing cellulitis, erysipelas, abscesses, and wound or burn infections [1]
Resistance was more common among MRSA than among methicillin-susceptible S. aureus (MSSA), and most of the data have been collected in adults, making the evaluation of the problem in children difficult; in some cases, resistance was high enough to strongly question the use of MU in the empirical treatment of pediatric impetigo
Some of them, such as DL and OM, belong to antibiotic classes for which use in pediatrics is contraindicated by the possible development of severe adverse events
Summary
Acute bacterial skin and soft tissue infections (aSSTIs) are a large group of diseases that can involve exclusively the skin, such as in the case of impetigo, or have a deeper localization, with the involvement of the underlying subcutaneous tissues, fascia, or muscles, causing cellulitis, erysipelas, abscesses, and wound or burn infections [1]. The aSSTI incidence has not always been the same It increased considerably in the early years of this century and stabilized or even slightly decreased [6,7]. This increase has been related to the emergence and diffusion of community-acquired methicillin-resistant S. aureus (CA-MRSA) [8]. It was suggested that, pending culture results, vancomycin, linezolid, daptomycin, telavancin, or clindamycin be used [9]. For all these drugs, some problems have emerged. The present knowledge on the potential role of these new antibiotics for the treatment of pediatric aSSTIs is discussed
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