Topical antimicrobials agents are an attractive therapeutic option due to the high
drug concentration achieved in the site of infection with minimal systemic absorption.
When used properly, they allow good cure rates with minimal systemic adverse effects
conferring great popularity to topical therapy. However the success of topically used drugs
entails its main disadvantage: antimicrobial resistance. Indiscriminate use leads to the
emergence of antimicrobial resistance hindering the response to treatment and, at
community level, risking potential serious systemic infections by resistant germens. These
risks prompt us to a judicious use of topical drugs.
In this chapter, topical antimicrobials are addressed focusing on microbiologic coverage
and clinical uses. Antibacterials are summarized including the recently appeared
nadifloxacin and retapamulin increasing the therapeutic arsenal against methicillinresistant
Staphilococcus aureus (MRSA) and mupirocin-resistant MRSA. Antivirals are
summarized including off-label uses for recalcitrant conditions. Antifungals are
summarized including the topical lacquer options for the combined therapy of
onychomycoses. Antiparasitic agents are summarized for the treatment of scabies and
pediculosis.
Keywords: Anti-infective agents, antibacterial agents, antifungal agents, antiparasitic
agents, antiviral agents, local administration, topical administration, cutaneous drug
therapy, topical antibiotics, topical antimicrobials skin.
