Featured Review: Interventions to reduce Staphylococcus aureus in the management of eczema

In this interview with review author Anjna Rani we learn more about the recently published review, Interventions to reduce Staphylococcus aureus in the management of eczema.

Tell us about this Cochrane Review  
This review looks at the evidence of treatments, such as antibiotics, antibacterial soaps/baths, to reduce a type of bacteria called Staphylococcus aureus (S. aureus) that is predominant on skin with eczema.  The review assessed a wide variety of treatments to help treat/reduce infected eczema – 41 studies involving 1753 participants were included in total.

Why is it important for patients with eczema?
Eczema is a frustrating skin condition with a number of different treatments. It is important for patients with eczema to understand the variety of treatments available and which one(s) would be suitable for them and are more likely to work to reduce impact on everyday life.

What can this review tell us about how effective treatments are to reduce skin infections in the management of eczema?  
Topical corticosteroid/antibiotic combinations are still prescribed widely due to effective marketing. Antiseptic wash products are also widely used, and antibiotics prescribed readily for “infected” eczema when what is needed is adequate control of skin inflammation.  Unfortunately, however, despite the number of trials included, there was so much variance in the types of treatment that the quality of evidence is low

How does this review link to a James Lind Alliance priority topic? (This is a shared priority, important to patients and health professionals.)
This was one of the top 10 questions, actually grouped in the health professional priorities, - “How effective are interventions to reduce skin infections in the management of eczema?”

Does the review point to more research being needed?
The conclusion of the review, “In view of the low quality of evidence and lack of information on quality of life and antibiotic resistance, a larger, definitive trial on steroid/antibiotic combination treatment is required. With the increased concerns about antibiotic resistance, other strategies to treat S. aureus infection that do not involve antibiotics should be further investigated.”