Abstract
Skin and soft tissue infections (SSTIs) are usually acute conditions of inflammatory microbial occupation of the skin layers and underlying soft tissues. SSTIs are one of the most frequent types of infection, typically requiring medical intervention and contribute to morbidity and mortality in both primary care and hospitalised patients. Due to the dramatic rise of antibiotic resistance, antiseptic agents can be potential alternatives for the prevention and treatment of SSTIs. Notably, they are commonly recommended in many global practical guidelines for use in per- and post- operative procedures. A range of antiseptics, including chlorhexidine, triclosan, alcohol, and povidone-iodine, are used and are mainly formulated as traditional, simple dosage forms such as solutions and semi-solids. However, in recent years, there have been studies reporting the potential for nanotechnology in the delivery of antiseptics. In this review, we have collated the scientific literature that focuses on topical antiseptic formulations for prevention and treatment of SSTIs, and have divided findings into traditional and advanced formulations. We conclude that although nanotechnological formulations have demonstrated potential advantages for delivering drugs; nevertheless, there is still scope for traditional formulations and further development of optimised topical formulations to address the rise of antimicrobial resistance.
Highlights
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Alcoholic Chlorhexidine gluconate (CHG) solutions at both 0.5% and 1.0% w/v concentrations were better than 10% w/v aqueous povidone-iodine (PVP-I) in minimizing microbial colony formation related to intravascular catheters [34]
This study indicated beneficial antibiofilm and antibacterial activity against Staphylococcus aureus, which is the key cause of orthopedic implant associated infections (OIAIs) [79]
Summary
Skin and soft tissue infections (SSTIs) refer to acute conditions of inflammatory microbial occupation of the skin layers and underlying soft tissues [1,2]. Disruption of the protective cutaneous layers can be caused by chemical and physical impacts such as ulceration, trauma, bites or surgical wounds, thermal injury, or previous inflammation [2,10] Both the patient and the environment are key factors contributing to the risk of developing an SSTI. It was reported that the proportion of hospital administrations caused by MRSA-related skin and soft tissue infections (SSTIs) declined by 29% over the five years [17]. Patients with dermatologic conditions often encounter physiological, psychological, as well as financial issues; that, many cutaneous concerns can lead to systemic diseases [18] Comorbidity factors, such as diabetes, immuno-compromisation, obesity, liver and kidney failure, and cardiovascular diseases, have repercussions on treatment costs and prolong the length of stay in hospital [19]. The purpose of this review paper is to collate the studies involving formulation of antiseptics for application via the topical route in the prevention and treatment of skin and soft tissue infections
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