Topical antibacterials: Current concepts and advances

Skin and mucosa act as a barrier against the entry of microbial agents, but loss of integrity of the skin weakens the host defense mechanisms and antimicrobials appear to play a role. Antibiotics have come a long way from penicillin which was accidentally discovered by Alexander Fleming when experimenting on influenza virus to the latest unnamed molecules. Recent topical antibiotics include retapamulin, nadifloxacin, dapsone, ozenoxacin, REP8839, and BAL19403. This article summarizes the current scientific information on newer topical antibiotics available along with overview of other old antibiotics, their indications in various fields, advantages of topical over oral antibiotics, available formulations, side effects, and precautions to be followed so as to minimize the emergence of drug resistance. Indiscriminate use of topical antibiotics is an important contributor for the development of bacterial resistance and should be curbed and they should be judiciously used. There is no ideal topical antibiotic, and clinicians must be watchful to identify the various patterns of antibiotic resistance.