Efficacy

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We found no RCTs that addressed this question in clinically infected atopic eczema.

Non-infected 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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