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Louis D. Eells, DO; Patricia M. Mertz; Yvette Piovanetti, MD; Gary M. Pekoe, PhD; William H. Eaglstein, MD

Arch Dermatol. 1986;122(11):1273-1276.

Abstract
• Because the effectiveness of topical antimicrobials in the treatment of ecthyma, impetigo, and pyoderma is not well established, the US Food and Drug Administration has recently proposed guidelines for tests of topical antimicrobial efficacy in primary skin infections. The guidelines require both comparison with the agent's base and microbiologic documentation of efficacy. These guidelines were followed in this double-blind, eight-day evaluation of impetigo/ecthyma treated with mupirocin, a new agent that is only active topically. All cultures, before and after therapy, were taken using swabs dipped in neutralizing broth plus 10% fetal bovine serum to minimize antimicrobial "carry over" to the culture plate. Staphylococcus aureus, which was isolated from 94% of the patients before therapy, was eliminated in 88% of the mupirocin-treated patients and 47% of the vehicletreated patients. Group A β-hemolytic streptococci were eliminated in 100% of the mupirocin-treated and 0% of the vehicle-treated patients. To our knowledge, this is the first topical antibacterial treatment for primary skin infections proved superior to its vehicle using the proposed US Food and Drug Administration guidelines.

(Arch Dermatol 1986;122:1273-1276)

Author Affiliations
From the Department of Dermatology, University of Pittsburgh School of Medicine (Drs Eells and Eaglstein and Ms Mertz); the Department of Pediatrics, University of Puerto Rico School of Medicine and San Juan City Hospital (Dr Piovanetti); and Beecham Laboratories, Bristol, Tenn (Dr Pekoe).

Footnotes
Accepted for publication June 20, 1986.

Reprint requests to Department of Dermatology, University of Pittsburgh School of Medicine, RC-513 Scaife Hall, Pittsburgh, PA 15261 (Dr Eaglstein).

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