Fusidic acid cream in the treatment of impetigo in general practice: double blind randomised placebo controlled trial

被引:60
作者
Koning, S
van Suijlekom-Smit, LWA
Nouwen, JL
Verduin, CM
Bernsen, RMD
Oranje, AP
Thomas, S
van der Wouden, JC
机构
[1] Erasmus Univ, Dept Gen Practice, NL-3000 DR Rotterdam, Netherlands
[2] Univ Rotterdam Hosp, NL-3000 DR Rotterdam, Netherlands
[3] Erasmus Univ, Dept Paediat, NL-3000 DR Rotterdam, Netherlands
[4] Erasmus Univ, Dept Med Microbiol & Infect Dis, NL-3000 DR Rotterdam, Netherlands
[5] Erasmus Univ, Dept Dermatovenereol, NL-3000 DR Rotterdam, Netherlands
来源
BMJ-BRITISH MEDICAL JOURNAL | 2002年 / 324卷 / 7331期
关键词
D O I
10.1136/bmj.324.7331.203
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective To test the hypothesis that fusidic acid would not increase the treatment effect of disinfecting with povidone-iodine alone in children with impetigo. Design Randomised placebo controlled trial. Setting General practices in Greater Rotterdam. Participants 184 children aged 0-12 years with impetigo. Main outcome measures Clinical cure and bacterial cure after one week. Results After one week of treatment 55% of the patients in the fusidic acid group were clinically cured compared with 13% in the placebo group (odds ratio 12.6,95% confidence interval 5.0 to 31.5, number needed to treat 2.3). After two weeks and four weeks the differences in cure rates between the two groups had become smaller. More children in the placebo group were non-compliant (12 v 5) and received extra antibiotic treatment (I I v 3), and more children in the placebo group reported adverse effects (19 v 7). Staphylococcus aureus was found in 96% of the positive cultures; no strains were resistant to fusidic acid. Conclusions Fusidic acid is much more effective than placebo (when both are given in combination with povidone-iodine shampoo) in the treatment of impetigo. Because of the low rate of cure and high rate of adverse events in the placebo group, the value of povidone-iodine in impetigo can be questioned.
引用
收藏
页码:203 / 206A
页数:7
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