BACKGROUND AND OBJECTIVE: Triclosan (2,4,4'-trichloro-2'-hydroxydiphenyl ether) is an antiseptic suitable for formulation as a W/O emulsion. The objective of the present study was to explore its potential utility in atopic dermatitis and prophylactic skin care following leg eczema and leg ulcer treatment. SUBJECTS AND METHODS: We performed in vitro susceptibility testing using the agar diffusion test on 602 isolates from swabs of our institution's Division of Dermatology. Additionally in an in vivo study with 15 healthy volunteers, the occlusion test and the expanded flora test were performed following the application of Hydrophobic Triclosan Cream 2% NRF (New German Formulary) 11.122. (TC) versus untreated, triclosan-free vehicle, 1% chlorhexidine digluconate solution, and ethanol 70%. RESULTS: In vitro susceptibility testing showed excellent activity against Staphylococcus aureus, Klebsiella species, and Proteus species. TC had little or no effect on Pseudomonas, beta-hemolytic streptococci, enterococci, and Candida species. In the in vivo study, TC produced a highly significant, quantitatively substantial reduction in aerobic bacterial counts versus untreated and versus vehicle. The 1% chlorhexidine digluconate solution was significantly more effective than TC in the expanded flora test. CONCLUSIONS: As S. aureus is a relevant pathogen in atopic dermatitis, and gram-negative organisms, including Klebsiella and Proteus species, as well as S. aureus play a major role in the prophylactic skin care after leg eczema and leg ulcer treatment, TC appears to be suitable for maintenance therapy in these indications.
BACKGROUND AND OBJECTIVE:Triclosan (2,4,4'-trichloro-2'-hydroxydiphenyl ether) is an antiseptic suitable for formulation as a W/O emulsion. The objective of the present study was to explore its potential utility in atopic dermatitis and prophylactic skin care following leg eczema and leg ulcer treatment. SUBJECTS AND METHODS: We performed in vitro susceptibility testing using the agar diffusion test on 602 isolates from swabs of our institution's Division of Dermatology. Additionally in an in vivo study with 15 healthy volunteers, the occlusion test and the expanded flora test were performed following the application of Hydrophobic Triclosan Cream 2% NRF (New German Formulary) 11.122. (TC) versus untreated, triclosan-free vehicle, 1% chlorhexidine digluconate solution, and ethanol 70%. RESULTS: In vitro susceptibility testing showed excellent activity against Staphylococcus aureus, Klebsiella species, and Proteus species. TC had little or no effect on Pseudomonas, beta-hemolytic streptococci, enterococci, and Candida species. In the in vivo study, TC produced a highly significant, quantitatively substantial reduction in aerobic bacterial counts versus untreated and versus vehicle. The 1% chlorhexidine digluconate solution was significantly more effective than TC in the expanded flora test. CONCLUSIONS: As S. aureus is a relevant pathogen in atopic dermatitis, and gram-negative organisms, including Klebsiella and Proteus species, as well as S. aureus play a major role in the prophylactic skin care after leg eczema and leg ulcer treatment, TC appears to be suitable for maintenance therapy in these indications.