One RCT evaluated topical antibiotics in the treatment of clinically infected atopic eczema (Table 17.6). Gentamicin cream was significantly less effective at reducing dermatitis activity than betamethasone valerate/gentamicin or betamethasone alone.13
Two RCTs have looked at topical antibiotics in people with clinically non-infected atopic eczema. In the first, which compared mupirocin ointment with placebo ointment (both with steroid), mupirocin (but not placebo) significantly reduced S. aureus compared with baseline, and clinical scores were significantly better in the mupirocin group than placebo. However, recolonisation occurred in the 4-week follow up period.14 Ramsay et al.12 showed that fusidic acid 2% cream resulted in more treatment failures than hydrocortisone/fusidic acid.
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