The emergence of bacterial resistance to commonly used antibiotics is not new. In this review we have tried to cover the ever increasing problems facing the treatment and containment of bacterial skin infections. We have tried to give an overview of the varied mechanisms by which bacteria gain and spread antimicrobial resistance, whilst dealing with the patterns of resistance exhibited by some of the commonly encountered organisms. Where there is evidence, we have formulated an approach on how to tackle antibiotic resistance. Where there is a lack of evidence we have formulated what we perceive to be appropriate guidelines.

Melioidosis is an emerging infection in Sri Lanka. Since the clinical presentation of melioidosis is not distinctive, a high index of clinical suspicion is required. Definitive diagnosis is usually made by isolation of the causative bacterium, Burkholderia pseudomallei, in culture. Although it is not a difficult bacterium to culture, initial identification of the isolate requires prior experience with B. pseudomallei. A case report of a patient with acute onset of lung abscess with a positive sputum culture for B. pseudomallei is presented.

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