The antibacterial-corticosteroid combination: What is its role in atopic dermatitis?

被引:16
作者
Williams R.E.A. [1 ,2 ]
机构
[1] Glan Clwyd Hospital, Bodelwyddan, Rhyl
[2] Glan Clwyd Hospital, Bodelwyddan, Rhyl
关键词
Dermatitis; Atopic Dermatitis; Topical Corticosteroid; Allergic Contact Dermatitis; Mupirocin;
D O I
10.2165/00128071-200001040-00002
中图分类号
学科分类号
摘要
The role of Staphylococcus aureus and therefore the place of combined antistaphylococcal and corticosteroid therapy in atopic dermatitis remains uncertain. While overt secondary infections such as furunculosis and impetigo respond rapidly to antibacterials, there is conflicting evidence as to the effect of antistaphylococcal therapy in atopic dermatitis that is not overtly infected. It is unlikely that antibacterials contribute to the management of mild atopic dermatitis. In more severe cases higher densities of S. aureus colonization are present. Antibacterials, whether topical or systemic, in combination with topical corticosteroids, may produce a more rapid decrease in S. aureus colonization than topical corticosteroids alone. Evidence for an accompanying greater speed in clinical improvement of the dermatitis is, however, mostly lacking. Topical antibacterial-corticosteroid combinations can be useful when treating small areas of skin for a limited period of time but are accompanied by the risk of sensitization and the emergence of resistant strains of bacteria. Systemic antibacterials in combination with topical corticosteroid are more appropriate when larger areas are involved.
引用
收藏
页码:211 / 215
页数:4
相关论文
共 32 条
[1]  
Leyden J.J., Marples R.R., Kligman A.M., Staphylococcus aureus in the lesions of atopic dermatitis, Br J Dermatol, 90, pp. 525-530, (1974)
[2]  
Williams R.E.A., Gibson A.G., Aitchison T.C., Et al., Assessment of a contact-plate sampling technique and subsequent quantitative bacterial studies in atopic dermatitis, Br J Dermatol, 123, pp. 493-501, (1990)
[3]  
Bibel D.J., Aly R., Shinefield H.R., Et al., The Staphylococcus aureus receptor for fibronectin, J Invest Dermatol, 80, pp. 494-496, (1983)
[4]  
Hay R.J., Adriaans B.M., Bacterial infections, Rook/Wilkinson/Ebling Textbook of Dermatology, pp. 1097-1179, (1998)
[5]  
Veien N.K., Antibiotics in bacterial skin infections, Br J Dermatol, 139, SUPPL. 53, pp. 30-36, (1998)
[6]  
White M.I., Noble W.C., The cutaneous reaction to staphylococcal protein A in patients with atopic dermatitis or psoriasis, Br J Dermatol, 113, pp. 179-183, (1985)
[7]  
McFadden J.P., Noble W.C., Camp R.D.R., Superantigenic exotoxin-secreting potential of staphylococci isolated from atopic eczematous skin, Br J Dermatol, 128, pp. 631-632, (1993)
[8]  
Jappe U., Heuck D., Witte W., Et al., Superantigen production by Staphylococcus aureus in atopic dermatitis: No more than a coincidence?, J Invest Dermatol, 110, 5, pp. 844-846, (1998)
[9]  
Zollner T.M., Kaufmann R., Superantigens in T cell mediated skin diseases - More than a coincidence, J Invest Dermatol, 112, 1, pp. 118-119, (1999)
[10]  
Wachs G.N., Maibach H.I., Co-operative double-blind trial of an antibiotic/corticoid combination in impetiginised atopic dermatitis, Br J Dermatol, 95, pp. 323-328, (1976)