Treatment with beta-lactam antibiotics in skin and soft tissue infections.

Beta-lactam antibiotics are highly effective against most bacteria causing skin and soft tissue infections. Good tissue penetration further makes beta-lactam antibiotics useful against skin and soft tissue infections. Drugs with a narrow spectrum should be among the first choice. Broader spectrum beta-lactam antibiotics may be needed in reduced bacterial susceptibility. Low molecular weight compounds (monobactams, penems, penicillinase inhibitors) in addition to their high antibacterial effect have shown excellent tissue penetration. In easy and moderately severe anaerobic infections not treatable with conventional oral beta-lactam antibiotics, other oral antibacterial agents (e.g. clindamycin, metronidazole) may be used rather than the parenteral recent acyl-ureidopenicillins or cephalosporins. Due to long duration of skin and soft tissue levels of drugs, it is unnecessary to administer beta-lactam antibiotics more than 2 or 3 times a day. Normal dosage schedules can be employed except in severely compromised elimination when decreased doses may be recommended or in immuno-compromised hosts and other risk patients who may require a 2- or 3-fold increase.