A review to elucidate the role and scope of topical ozenoxacin in routine surgical practice in India
DOI:
https://doi.org/10.18203/2349-2902.isj20251201Keywords:
Surgical site infections, Ozenoxacin, Topical antibioticsAbstract
Superficial skin infections are a prevalent and are a significant challenge in surgical practice, particularly in India, where high surgical volumes and a high prevalence of comorbidities elevate the risk of infection. The use of topical antibiotics is a widely known strategy for preventing and managing superficial skin infections, yet the rise of antibiotic resistance demands innovative solutions. Based on the clinical evidence, epidemiology of superficial skin infections in surgical practice, risk factors, and panel discussion, this expert opinion aims to guide clinicians to optimize the use of ozenoxacin in surgical practice. The role of ozenoxacin, a novel fluoroquinolone, has been explored as an effective topical antibiotic for the treatment of superficial skin infection seen in surgical practice such as cellulitis, erysipelas, impetigo, ecthyma, folliculitis, furuncles, carbuncles, abscesses, and infections related to minor trauma. The article highlights ozenoxacin’ s mechanism of action, its broader antimicrobial coverage against gram-positive pathogens, and its potential advantages over older topical antibiotics.
Metrics
References
Leermakers MEJ, Pleunis N, Boll D, Hermans RH, Ezendam NPM, Pijnenborg JMA. High Incidence of Erysipelas After Surgical Treatment for Vulvar Carcinoma: An Observational Study. Int J Gynecol Cancer Off J Int Gynecol Cancer Soc. 2016;26(3):582-7. DOI: https://doi.org/10.1097/IGC.0000000000000625
Ellis Simonsen SM, Van Orman ER, Hatch BE, Jones SS, Gren LH, Hegmann KT, et al. Cellulitis incidence in a defined population. Epidemiol Infect. 2006;134(2):293-9. DOI: https://doi.org/10.1017/S095026880500484X
Lake AG, McPencow AM, Dick-Biascoechea MA, Martin DK, Erekson EA. Surgical site infection after hysterectomy. Am J Obstet Gynecol. 2013;209(5):490.e1-9. DOI: https://doi.org/10.1016/j.ajog.2013.06.018
Dallo M, Patel K, Hebert AA. Topical Antibiotic Treatment in Dermatology. Antibiotics. 2023;12(2):188.
Ozenoxacin: A novel topical antibiotic - Indian Journal of Dermatology, Venereology and Leprology. Available at: https://ijdvl.com/ ozenoxacin-a-novel-topical-antibiotic/. Accessed on 22 January 2025.
Mekhla, Borle FR. Determinants of superficial surgical site infections in abdominal surgeries at a Rural Teaching Hospital in Central India: A prospective study. J Fam Med Prim Care. 2019;8(7):2258-63. DOI: https://doi.org/10.4103/jfmpc.jfmpc_419_19
Mezemir R, Seid A, Gishu T, Demas T, Gize A. Prevalence and root causes of surgical site infections at an academic trauma and burn center in Ethiopia: a cross-sectional study. Patient Saf Surg. 2020;14(1):3. DOI: https://doi.org/10.1186/s13037-019-0229-x
Bath MF, Davies J, Suresh R, Machesney MR. Surgical site infections: a scoping review on current intraoperative prevention measures. Ann R Coll Surg Engl. 2022;104(8):571-6. DOI: https://doi.org/10.1308/rcsann.2022.0075
Ansari S, Hassan M, Barry HD, Bhatti TA, Hussain SZM, Jabeen S, et al. Risk Factors Associated with Surgical Site Infections: A Retrospective Report from a Developing Country. Cureus. 2006;11(6):e4801.
Kowalewski M, Pasierski M, Makhoul M, Comanici M, Dąbrowski EJ, Matteucci M, et al. Topical vancomycin for sternal wound infection prophylaxis. A systematic review and updated meta-analysis of over 40,000 cardiac surgery patients. Surgery. 2023;174(5):1102-12. DOI: https://doi.org/10.1016/j.surg.2023.05.031
Ashraf DC, Idowu OO, Wang Q, YeEun T, Copperman TS, Tanaboonyawat S, et al. The Role of Topical Antibiotic Prophylaxis in Oculofacial Plastic Surgery: A Randomized Controlled Study. Ophthalmology. 2020;127(12):1747-54. DOI: https://doi.org/10.1016/j.ophtha.2020.07.032
Jin L, Ba T. Effect of prolonged antibiotic prophylaxis on the occurrence of surgical site wound infection after instant breast reconstruction: A meta‐analysis. Int Wound J. 2023;21(4):e14631. DOI: https://doi.org/10.1111/iwj.14631
Hall LM, Gorges HJ, van Driel M, Magin P, Francis N, Heal CF. International comparison of guidelines for management of impetigo: a systematic review. Fam Pract. 2022;39(1):150-8. DOI: https://doi.org/10.1093/fampra/cmab066
Tong QJ, Hammer KD, Johnson EM, Zegarra M, Goto M, Lo TS. A systematic review and meta-analysis on the use of prophylactic topical antibiotics for the prevention of uncomplicated wound infections. Infect Drug Resist. 2018;11:417-25. DOI: https://doi.org/10.2147/IDR.S151293
Lee JJ, Chibueze S, Walia A, Yaeger LH, Zenga J, Puram SV, et al. Infection Control With Topical Antimicrobial Prophylaxis for Mucosal Head and Neck Surgery: A Meta-analysis. Otolaryngol--Head Neck Surg Off J Am Acad Otolaryngol-Head Neck Surg. 2023;168(3):261-8. DOI: https://doi.org/10.1177/01945998221100801
Zabaglo M, Leslie SW, Sharman T. Postoperative Wound Infections. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2025. Available at: http://www.ncbi.nlm.nih.gov/books/NBK560533/. Accessed on 22 January 2025.
Bandyopadhyay D. Topical Antibacterials in Dermatology. Indian J Dermatol. 2021;66(2):117-25.
Neri I, Miraglia del Giudice M, Novelli A, Ruggiero G, Pappagallo G, Galli L. Ideal Features of Topical Antibiotic Therapy for the Treatment of Impetigo: An Italian Expert Consensus Report. Curr Ther Res. 2023;98:100690. DOI: https://doi.org/10.1016/j.curtheres.2022.100690
Ramakrishnan K, Salinas RC, Higuita NIA. Skin and Soft Tissue Infections. Am Fam Physician. 2015;92(6):474-83.
Worster B, Zawora MQ, Hsieh C. Common Questions About Wound Care. Am Fam Physician. 2015;91(2):86-92.
Jatoliya H, Pipal RK, Pipal DK, Biswas P, Pipal VR, Yadav S, et al. Surgical Site Infections in Elective and Emergency Abdominal Surgeries: A Prospective Observational Study About Incidence, Risk Factors, Pathogens, and Antibiotic Sensitivity at a Government Tertiary Care Teaching Hospital in India. Cureus. 2023;15(10):e48071. DOI: https://doi.org/10.7759/cureus.48071
Chen PJ, Hua YM, Toh HS, Lee MC. Topical antibiotic prophylaxis for surgical wound infections in clean and clean-contaminated surgery: a systematic review and meta-analysis. BJS Open. 2021;5(6):zrab125. DOI: https://doi.org/10.1093/bjsopen/zrab125
Lin WL, Wu LM, Nguyen THY, Lin YH, Chen CJ, Huang WT, et al. Topical Antibiotic Prophylaxis for Preventing Surgical Site Infections of Clean Wounds: A Systematic Review and Meta-Analysis. Surg Infect. 2024;25(1):32-8. DOI: https://doi.org/10.1089/sur.2023.182
Qin X, Huang H. Review of nemonoxacin with special focus on clinical development. Drug Des Devel Ther. 2014;8:765-74. DOI: https://doi.org/10.2147/DDDT.S63581
Stubbings W, Leow P, Yong GC, Goh F, Körber-Irrgang B, Kresken M, et al. In Vitro Spectrum of Activity of Finafloxacin, a Novel, pH-Activated Fluoroquinolone, under Standard and Acidic Conditions. Antimicrob Agents Chemother. 2011;55(9):4394-7. DOI: https://doi.org/10.1128/AAC.00833-10
Vila J, Hebert AA, Torrelo A, López Y, Tato M, García-Castillo M, et al. Ozenoxacin: a review of preclinical and clinical efficacy. Expert Rev Anti Infect Ther. 2019;17(3):159-68.
Sahu M, Dubey DV, Maral MA. Ozenoxacin: A Comprehensive Review of its Pharmacological Properties, Clinical Efficacy, and Emerging Applications in the Treatment of Bacterial Skin Infections. Int J Pharma Res Appl. 2023;8(5):901-11.
New Therapeutic Applications of Topical Ozenoxacin in Superficial Skin Infections Other Than Non-Bullous Impetigo - Walter Bushnell Healthcare Foundation. Available at: https://wbhf.walterbushnell.com/publications/pedia-flash/item/532-new-therapeutic-applications-of-topical-ozenoxacin-in-superficial-skin-infections-other-than-non-bullous-impetigo. Accessed on 22 January 2025.
Winters RD, Mitchell M. Folliculitis . In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2025. Available at: http://www.ncbi.nlm.nih.gov/ books/NBK547754/. Accessed on 18 March 2025.
Troxell T, Hall CA. Carbuncle. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2025. Available at: http://www.ncbi.nlm.nih.gov/ books/NBK554459/. Accessed on 18 March 2025.
Michael Y, Shaukat NM. Erysipelas . In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2025. Available at: http://www.ncbi.nlm.nih.gov/ books/NBK532247/. Accessed on 18 March 2025.
Herbert R, Caddick M, Somerville T, McLean K, Herwitker S, Neal T, et al. Potential new fluoroquinolone treatments for suspected bacterial keratitis. BMJ Open Ophthalmol. 2022;7(1):e001002. DOI: https://doi.org/10.1136/bmjophth-2022-001002
Bandyopadhyay D. Topical Antibacterials in Dermatology. Indian J Dermatol. 2021;66(2):117-25. DOI: https://doi.org/10.4103/ijd.IJD_99_18
The Use of Ozenoxacin in Pediatric Patients: Clinical Evidence, Efficacy and Safety - PMC. Available at: https://pmc.ncbi.nlm.nih.gov/ articles/PMC7751750/. Accessed on 22 January 2025.
Santhosh P, Thomas MH. Ozenoxacin: A novel topical antibiotic. Indian J Dermatol Venereol Leprol. 2021;87(1):131-4. DOI: https://doi.org/10.25259/IJDVL_191_20
Sahu JK, Mishra AK. Ozenoxacin: A Novel Drug Discovery for the Treatment of Impetigo. Curr Drug Discov Technol. 2019;16(3):259-64. DOI: https://doi.org/10.2174/1570163815666180502165014
Zhanel GG, Adam HJ, Baxter M, Lagace-Wiens PRS, Karlowsky JA. In vitro activity and resistance rates of topical antimicrobials fusidic acid, mupirocin and ozenoxacin against skin and soft tissue infection pathogens obtained across Canada (CANWARD 2007-18). J Antimicrob Chemother 2021;76(7):1808-14. DOI: https://doi.org/10.1093/jac/dkab098
Dallo M, Patel K, Hebert AA. Topical Antibiotic Treatment in Dermatology. Antibiotics. 2023;12(2):188. DOI: https://doi.org/10.3390/antibiotics12020188
Park SY, Kim SM, Park SD. The Prevalence, Genotype and Antimicrobial Susceptibility of High- and Low-Level Mupirocin Resistant Methicillin-Resistant Staphylococcus aureus. Ann Dermatol. 2012;24(1):32-8. DOI: https://doi.org/10.5021/ad.2012.24.1.32
García Ron G, Villa Arranz M. New therapeutic applications of ozenoxacin in superficial skin infections. Dermatol Rep. 2022;14(2):9289. DOI: https://doi.org/10.4081/dr.2021.9289
Vila J, Hebert AA, Torrelo A, López Y, Tato M, García-Castillo M, et al. Ozenoxacin: a review of preclinical and clinical efficacy. Expert Rev Anti Infect Ther. 2019;17(3):159-68. DOI: https://doi.org/10.1080/14787210.2019.1573671