The Impact of Treating Staphylococcus Aureus Infection and Colonization on the Clinical Severity of Atopic Dermatitis
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Purpose
Staphylococcus aureus (S. aureus) infection is perceived not only as a common secondary complication of atopic dermatitis (AD), but also as a culprit in the worsening of this condition. In addition, the recent development of community acquired methicillin-resistant S. aureus (CA-MRSA) has presented a new challenge to our management of AD, both in treatment of acute infections and maintenance therapy. The investigators would like to perform a randomized investigator-blinded placebo-controlled study of children aged 6 months to 17 years with moderate to severe atopic dermatitis with clinical signs of secondary bacterial infection to study: 1) the prevalence of CA-MRSA in our patient population; 2) the relationship of sensitivity of the S. aureus organism cultured from the infected lesion(s) to clinical response to oral cephalexin therapy and severity of the AD; and 3) whether concurrent treatment of S. aureus infection initially with nasal mupirocin ointment and sodium hypochlorite (bleach) baths can result in long-term S. aureus eradication and clinical stability.
| Condition | Intervention | Phase |
|---|---|---|
|
Atopic Dermatitis |
Drug: Sodium hypochlorite (bleach) baths Drug: Mupirocin ointment Drug: Water Drug: Petrolatum Ointment |
Phase 4 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Investigator) Primary Purpose: Treatment |
| Official Title: | The Impact of Treating Staphylococcus Aureus Infection and Colonization on the Clinical Severity of Atopic Dermatitis |
- Change in Eczema Area and Severity Index (EASI)Scores According to Location [ Time Frame: Baseline and 3 months ] [ Designated as safety issue: No ]The proportion of affected body surface area (BSA) was estimated from 4 designated body regions(head/neck, upper limbs, trunk, and lower limbs),and the Physician's Assessment of Individual Signs was determined for each region by grading signs of AD on a 4-point scale. Both the proportion of affected BSA and the Physician's Assessment of Individual Signs score were used to calculate the EASI score,a validated composite score that ranges from 0 (clear) to 72 (very severe).
| Enrollment: | 31 |
| Study Start Date: | September 2005 |
| Study Completion Date: | March 2011 |
| Primary Completion Date: | March 2011 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: Treatment
Intranasal mupirocin ointment treatment and sodium hpochlorite (bleach baths)
|
Drug: Sodium hypochlorite (bleach) baths
Sodium hypochlorite baths twice weekly for three months
Other Name: Bleach
Drug: Mupirocin ointment
Intranasal mupirocin 2% ointment BID x five days (3 times total for subjects; one time only for family members)
Other Name: Centany
|
|
Placebo Comparator: Placebo
Intranasal petrolatum ointment treatment and plain water baths
|
Drug: Water
Water baths twice weekly for three months
Drug: Petrolatum Ointment
Intranasal petrolatum ointment twice daily for five days
Other Name: Vaseline
|
Show Detailed Description
Eligibility| Ages Eligible for Study: | 6 Months to 17 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- 6 months to 17 years of age
- Moderate to severe atopic dermatitis
Exclusion Criteria:
- Use of cephalexin or other antibiotic in last 6 weeks
- Allergy to cephalosporins
Contacts and Locations| United States, Illinois | |
| Childrens Memorial Hospital | |
| Chicago, Illinois, United States, 60614 | |
| Principal Investigator: | Amy Paller, MD | Childrens Memorial Hospital |
More Information
Publications:
| Responsible Party: | Amy Paller, Professor and Chair of Department of Dermatology, Professor of Pediatrics, Northwestern University |
| ClinicalTrials.gov Identifier: | NCT00179959 History of Changes |
| Other Study ID Numbers: | 12624 |
| Study First Received: | September 13, 2005 |
| Results First Received: | April 4, 2011 |
| Last Updated: | November 29, 2012 |
| Health Authority: | United States: Institutional Review Board |
Additional relevant MeSH terms:
|
Dermatitis Dermatitis, Atopic Skin Diseases Skin Diseases, Genetic Genetic Diseases, Inborn Skin Diseases, Eczematous Hypersensitivity, Immediate Hypersensitivity Immune System Diseases Sodium Hypochlorite Eusol Mupirocin |
Petrolatum Disinfectants Anti-Infective Agents Therapeutic Uses Pharmacologic Actions Emollients Dermatologic Agents Protein Synthesis Inhibitors Enzyme Inhibitors Molecular Mechanisms of Pharmacological Action Anti-Bacterial Agents |
ClinicalTrials.gov processed this record on May 19, 2013