Prospective study of pyoderma-bacteria and their in-vitro-antibiotic susceptibility

Background and Objective. For rational therapeutic recommendations the spec trum and resistance of bacteria in skin diseases were investigated. Patients/Methods. Within 4 months 911 swabs of dematoses possibly caused by bacteria were taken prospectively (481 outpatients, 430 inpatients) and th e material cultured on standard media. The positive cultures including resi stance screening of 210 swabs of 168 outpatients and of 175 swabs of 85 inp atients could be evaluated, the remaining cultures were sterile. Results. Staphylococcus aureus was the most frequent pathogen (outpatient 6 7 %, inpatient 61% of all positive cultures), followed by streptococci (gro ups A and B; 25%). In patients Pseudomonas aeruginosa was the most common p athogen in leg ulcers and between the toes (45% and 70% respectively). 13% of the Staphylococcus aureus isolates were resistant to tetracyclines and e rythromycin;one strain proved to be methicillin resistant. Conclusions. Cephalosporins (I. generation), penicillins with P-lactamase-i nhibitors,and to a lesser extent isoxazoyl-penicillin and clindamycin can b e recommended for the treatment of skin infections. Oral quinolones are sui ted for infections with gram-negative bacteria (such as beween the toes). T he indications for systemic antibiotic therapy of leg ulcers should be rest ricted.