We found no RCTs that addressed this question in clinically infected atopic eczema.
We located three RCTs that have demonstrated the effectiveness of topical steroids in reducing S. aureus in clinically non-infected atopic eczema. In the study by Stalder et a/.10 topical desonide was significantly better than its excipient alone at reducing S. aureus and global clinical score. In the second study,11 Group A compared a moderate-strength steroid with an alternative similar steroid in propylene glycol (antiseptic) base; Group B compared a potent steroid with potent steroid plus neomycin (antibiotic). In both groups, the addition of the antimicrobial did not improve clinical outcome. In the third study12 1% hydrocortisone was as effective as 1% hydrocortisone/2% fusidic acid in terms of overall clinical outcome, although the combination treatment was more effective at reducing S. aureus.12
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