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We found four RCTs evaluating steroid/antibiotic combinations for clinically infected atopic eczema1315-17 (Table 17.6).

Versus vehicle

The study by Thaci et a/.15 showed superior benefit of both betamethasone/fusidic acid ointment and cream over vehicle alone, with no significant difference between cream and ointment.

Versus topical steroid

Two RCTs found no significant difference in clinical signs or symptoms when betamethasone valerate/fusidic acid16 or betamethasone/ gentamicin13 were compared with topical steroid alone.

Versus each other

There was no significant difference between 0-1% betamethasone/2% fusidic acid and 0-1% betamethasone/0-5% neomycin in terms of clinical efficacy or ability to eradicate S. aureus.1

Non-infected eczema

One further RCT was located that has evaluated topical steroid/antibiotic treatment for non-clinically infected atopic eczema. In this study, 2% fusidic acid/1% hydrocortisone showed no clear benefit over 1% hydrocortisone alone in reducing atopic eczema activity, but it was significantly better at reducing S. aureus.12

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