SKIN AND SOFT TISSUE INFECTIONS: Edited by Matteo BassettiThe eternal dilemma of antitoxin antibiotics for skin and soft tissue infectionBurillo, Almudenaa,b,c; Bouza, Emilioa,b,c,dAuthor Information aDepartment of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón bMedicine Department, School of Medicine, Universidad Complutense de Madrid cGregorio Marañón Health Research Institute dCIBER of Respiratory Diseases (CIBERES CB06/06/0058), Madrid, Spain Correspondence to Emilio Bouza, MD, PhD, Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Doctor Esquerdo 46, 28007 Madrid, Spain. Tel: +34 91 586 84 53; fax: +34 91 586 87 67; e-mail: [email protected] Current Opinion in Infectious Diseases: April 2021 - Volume 34 - Issue 2 - p 80-88 doi: 10.1097/QCO.0000000000000711 Buy Metrics Abstract Purpose of review In standard clinical practice, combined antibiotic treatment is used to treat severe skin and soft tissue infections (SSTIs), whereby one of the drugs is usually a protein synthesis inhibitor antibiotic. However, evidence for this practice is only based on data from ‘in vitro’ studies, animal models and case reports. There are no randomized controlled trials. In the light of several new drugs marketed for the treatment of these infections, there is a need to revise the state of the art. Recent findings New reviews and systematic appraisals of the literature exist on the use of protein synthesis inhibitor antibiotics to treat severe SSTI. Several ‘in vitro’ studies have assessed the efficacy of some of the new drugs. Summary Combination therapy, including an adjuvant protein synthesis inhibitor antibiotic for toxin suppression, should be used both in patients with severe SSTI and in those with moderate infection and risk factors for methicillin-resistant positive- or Panton–Valentine leukocidin positive-Staphylococcus aureus infection. Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.