A northern Australian research team has debunked the call to restrict oral treatment options for patients with skin infections, finding that there has been inaccurate reporting of resistance to the recommended antibiotic.

Led by Menzies School of Health Research (Menzies), the findings of the investigation into the reported resistance have recently been published in the journal, Clinical Microbiology and Infection.

In northern Australia, especially in remote communities, Staphylococcus aureus, otherwise known as golden staph, carries a high burden of disease. Eight out of 10 children living in remote Indigenous communities acquire skin sores, as a result of staph and strep infections, at least once before their first birthday.

The ground-breaking study, the Skin Sore Trial, led by Menzies and released in 2014, discovered a pain-free oral treatment option for patients which was more conducive to uptake than the previous intramuscular injection. The oral antibiotic, called trimethoprim- sulfamethoxazole (Bactrim), has been recommended for treatment of skin sores since.

However, recent reports that strains of Staphylococcus aureus may have been resistant to Bactrim, has led to a concern about ongoing prescribing of the oral antibiotic.

According to Menzies’ and Peter Doherty Institute for Infection and Immunity infectious diseases specialist, Associate Professor Steven Tong and Menzies researcher Dr Tegan Harris, the investigation into the possible resistance to Bactrim was critical to ensure appropriate treatment was being offered to children.

“During the Skin Sore Trial, we detected that some of the golden staph from skin sores were reported as resistant to Bactrim with standard laboratory testing. When we tried to confirm this resistance with additional testing, we were surprised to find that the staph could be easily killed with Bactrim,” Dr Harris said.

“We consistently found in two laboratories and by several different techniques that the staph was actually susceptible and not resistant to Bactrim. The implications are that current recommendations to treat skin infections with Bactrim continue to be appropriate,” Assoc Prof Tong said.

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