Emollient formulations containing antiseptics reduce effectively the level of Staphylococcus aureus on skin

Abstract

Background

Increased skin colonization by Staphylococcus aureus is associated with atopic eczema (AE) severity. Reduction of S. aureus levels on the skin results in an improvement in the clinical condition.

Methods

The antimicrobial activity of topical products including a bath oil, cream, and wash combining antiseptics and emollients (A+E) was compared to products containing emollients only. The preference of patients with AE for A+E cream or emollient only cream to relieve symptoms of itching, erythema, and inflammation when applied three times daily for 10 days is evaluated. Repeat insult patch testing of the products is also conducted.

Results

A significant reduction in microbial counts was found following use of A+E bath oil (4.09±0.32 vs 6.20±0.24 log₁₀ cfu/mL S. aureus, P<0.001), A+E cream (5.50±0.63 vs 5.94±0.72 log₁₀ cfu/foot S. aureus, P=0.002), and A+E wash (2.71±0.48 vs 3.57±0.31 log₁₀ cfu/mL Escherichia coli, P<0.001) compared to the emollient only products. The A+E cream was preferred to the emollient only cream (P=0.004) by patients with AE. All three tested formulations were found to be non-irritating and non-sensitizing to the skin.

Conclusion

The bath oil, cream, and wash containing antiseptics and emollients decrease the level of bacteria on the skin, including S. aureus, compared to emollient only products. Patients with AE preferred the A+E cream compared to the emollient only cream to relieve symptoms of itching, erythema, and inflammation. The choice of formulation allows clinicians and patients to choose a suitable product for the short-term treatment of eczema flare-ups caused by bacterial infections.

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Keywords:

• Staphylococcus aureus
• atopic eczema
• atopic dermatitis
• benzalkonium chloride
• triclosan
• antimicrobial
• antiseptic
• emollient

Acknowledgment

The authors wish to thank AMA Laboratories, Inc., Cantor Research Laboratories, Inc., Dermatest, Pty. Ltd., Microtech Laboratories, Pty. Ltd. and Silliker Microtech, Pty. Ltd. for their help performing these studies.

Disclosure

Fabrizio Spada, Tanya M Barnes and Kerryn A Greive are, or at the time of the research were employed by Ego Pharmaceuticals, the sponsor of the study and manufacturer of the QV Flare Up product range. The authors report no other conflicts of interest in this work.