Chapter 4. Antibacterial/steroid combination therapy in infected eczema

Abstract

"Infection with Staphylococcus aureus is common in all forms of eczema. Production of superantigens by S. ­aureus increases skin inflammation in eczema; antibacterial treatment is thus pivotal. Poor patient compliance is a major cause of treatment failure; combination preparations that contain an antibacterial and a topical steroid and that work quickly can improve compliance and thus treatment outcome. Fusidic acid has advantages over other avail­able topical antibacterial agents – neomycin, gentamicin, clioquinol, chlortetracycline, and the antifungal agent miconazole. The clinical efficacy, antibacterial activity and cosmetic acceptability of fusidic acid/corticosteroid combinations are similar to or better than those of comparator combinations. Fusidic acid/steroid combinations work quickly with observable improvement within the first week. Studies have shown that short-term (2 weeks) use of fusidic acid/corticosteroid combinations does not increase the development of resistance. A new formulation of fusidic acid with betamethasone valerate in a lipid cream also addresses xerosis in eczema."