Abstract：
We reviewed the first revision of the clinical practice guidelines on the management of bacterial skin infections developed by the Dutch College of General Practitioners. Bacterial skin infections are subdivided into superficial and deep infections; the former are often treated locally while the latter may require systemic antibiotics or surgical intervention. The rate of infection with methicillin-resistant Staphylococcus aureus (MRSA) in the community is relatively low in The Netherlands, but the guideline provides recommendations, such as the restricted use of mupirocin ointment, to facilitate future MRSA control measures. Clinical distinction between erysipelas and cellulitis is often impossible; therefore, the term cellulitis is used throughout the guideline and refers to both Staphylococcus aureus and Streptococcus pyogenes infections of the skin and subcutaneous tissue. The first line of therapy for cellulitis remains a small spectrum, beta-lactamase resistant penicillin, such as flucloxacillin for 10 days. There are no conclusive studies on the prevention of recurrent cellulitis, so recommendations are based on expert opinion and pathophysiological considerations. The lack of rigorous and controlled studies often precludes making clear evidence-based recommendations. However, this guideline succeeds remarkably well in combining the available evidence and formulating sound practical management advice for bacterial skin infections in primary care in The Netherlands. It deserves widespread implementation among general practitioners.
摘要：
我们回顾了荷兰全科医师学院制定的细菌性皮肤感染管理临床实践指南的第一次修订。细菌性皮肤感染分为浅表和深部感染；前者通常在局部治疗，而后者可能需要全身性抗生素或手术干预。荷兰社区耐甲氧西林金黄色葡萄球菌(MRSA)感染率相对较低,但是指南提供了建议，如限制使用莫匹罗星软膏，以促进未来的MRSA控制措施。丹毒和蜂窝织炎之间的临床区别通常是不可能的；因此，术语蜂窝织炎在整个指南中使用,是指皮肤和皮下组织的金黄色葡萄球菌和化脓性链球菌感染.蜂窝织炎的一线治疗仍然是一个小范围，β-内酰胺酶耐药青霉素，如氟氯西林10天。目前尚无关于预防复发性蜂窝织炎的结论性研究,因此，建议是基于专家意见和病理生理考虑。缺乏严格和受控的研究通常无法提出明确的循证建议。然而,本指南在结合现有证据并为荷兰初级保健中的细菌性皮肤感染制定合理的实用管理建议方面取得了显著成功.值得在全科医生中广泛实施。
