OxyFile #327

Hydrogen peroxide cream: an alternative to topical antibiotics 
in the treatment of impetigo contagiosa.


Author:   Christensen OB; Anehus S

Source:   Acta Derm Venereol 1994 Nov; 74(6):460-2

Abstract:

In total, 256 patients with bacteriologically verified 
impetigo contagiosa were included in three double-blind, 
parallel group, randomized, multi-centre trials, where 
the efficacy of hydrogen peroxide cream (Microcid) was 
compared with that of fusidic acid cream/gel (Fucidin). 
The trials were performed at 47 centres in three countries, 
Sweden, Germany and UK, and the results are compiled in 
the present report. During the course of the 3-week treatment 
period, 92 patients out of 128 (72%) in the Microcid group 
were classified as healed, compared to 105 patients out 
of 128 (82%) in the Fucidin group. This difference was 
not statistically significant. The reduction in composite 
sign severity score (the sum of the score for erythema, 
vesiculation/bullae, weeping and crusting divided by four) 
in each separate study was 73%, 78% and 84% in the Microcid 
group and 85%, 85% and 84% in the Fucidin group. No statistically 
significant differences were found in the separate studies 
or when compiling the studies in a meta-analysis. When 
the patients had been classified as healed, beta-haemolytic 
streptococci were eliminated in all patients treated with 
Microcid cream. Since treatment started before the result 
of the bacteriology was known, another 135 patients with 
negative skin culture were enrolled in the trials, i.e. 
391 patients were included in the safety analysis. Out 
of these, 23 patients reported the occurrence of adverse 
events, mainly classified as mild. In conclusion, Microcid 
cream has been documented as a topical alternative to fusidic 
acid in the treatment of impetigo.