Category: signaling
Topical antimicrobial pharmacology for skin + soft tissue infection + ectoparasitic infestation. Subcategories by target: (1) Antibacterial — mupirocin (pseudomonic acid; isoleucyl-tRNA synthetase inhibitor — protein synthesis block; MRSA decolonization mainstay; FDA-approved for impetigo + folliculitis); clindamycin-topical (acne, hidradenitis suppurativa — 50S ribosomal subunit); metronidazole-topical (rosacea — anti-anaerobic + anti-inflammatory mechanism); chlorhexidine (broad-spectrum antiseptic — disrupts bacterial membrane; surgical skin prep + chronic decolonization). (2) Antifungal — clotrimazole + ketoconazole (CYP51 azoles for dermatophytes + Candida + Malassezia); terbinafine (squalene epoxidase — ergosterol synthesis block; onychomycosis gold standard); ciclopirox; griseofulvin. (3) Antiparasitic — permethrin (pyrethroid sodium-channel modulator; scabies + lice 1st-line); ivermectin (oral or topical 1% — scabies, demodicosis, rosacea); spinosad; lindane (historical, neurotoxic — restricted). (4) Anti-acne — benzoyl peroxide (ROS-mediated kill of C. acnes); azelaic acid; topical retinoids. Resistance landscape: mupirocin-resistant MRSA + chlorhexidine-tolerance emerging; rotating agents for chronic decolonization. Cross-links: [[bacterial_translation_inhibition]] (mupirocin/clindamycin), [[fungal_ergosterol_biosynthesis]] (terbinafine/azoles), [[voltage_gated_sodium_channels]] (permethrin), [[helminth_protozoa_targets]] (ivermectin).