There are no RCTs of antiseptics in clinically infected atopic eczema.
We located six RCTs of antiseptics in non-clinically infected eczema,22-27 summarised in Table 17.7.
Antiseptic versus standard bath emollient:
Two RCTs have compared a standard bath emollient, Oilatum (acetylated wool alcohols 5%, liquid paraffin 63-4%) with an emollient plus antiseptic, Oilatum Plus ( benzalkonium chloride 6%, triclosan 2%, light liquid paraffin 52-5%). No significant difference was demonstrated in terms of clinical or microbiological outcomes.22,23
This study compared a soap containing 1-5% triclocarbon with an identical placebo soap. The authors state that the global change in atopic eczema severity was significantly greater in the treatment than the placebo group, but the actual data are missing. Graphical data suggest a similar degree of improvement in both groups.24
How effective are topical antifungals?
Two RCTs were identified. The first study reported improvement on the arm treated with daily povidine iodine solution but not on the untreated side, compared with baseline.25 In the second study, acid electrolytic water sprayed onto infants significantly reduced clinical scores and S. aureus counts compared with baseline. Neither study reported a comparison of treatments.26
This study compared a proprietary brand of chlorhexidine with a 1:20 000 dilution of potassium permanganate, in addition to topical steroid in both groups, and found no significant difference in clinical or bacteriological outcomes.10
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