Floor M van Diek1, Nathalie Pruijn2, Karin M Spijkers3, Bert Mulder4, Nienke M Kosse2, Oscar Dorrestijn5. 1. Department of Orthopaedic Surgery, Sint Maartenskliniek, Nijmegen, The Netherlands. Electronic address: f.vandiek@gmail.com. 2. Sint Maartenskliniek Research, Nijmegen, The Netherlands. 3. Department of Pharmacy, Sint Maartenskliniek, Nijmegen, The Netherlands. 4. Department of Medical Microbiology and Infectious Diseases, Canisius-Wilhelmina Ziekenhuis, Nijmegen, The Netherlands. 5. Department of Orthopaedic Surgery, Sint Maartenskliniek, Nijmegen, The Netherlands.
Abstract
HYPOTHESIS AND BACKGROUND: We hypothesized that benzoyl peroxide (BPO) would reduce the presence of Cutibacterium acnes on the skin of the shoulder by 50% compared with placebo. Infections after shoulder surgery are most commonly caused by C acnes. Current prophylactic methods do not effectively reduce the bacterial load of this bacterium. However, it seems that BPO may reduce C acnes on the skin of the shoulder. Therefore, this study aimed to investigate the effect of BPO on the presence of C acnes on the shoulder skin. METHODS: A double-blinded, randomized, placebo-controlled trial was performed including healthy participants aged between 40 and 80 years. Thirty participants with C acnes on the shoulder skin according to baseline skin swabs were randomized into the BPO or placebo group. After gel application 5 times, skin swabs were taken to determine the presence of C acnes. RESULTS:Forty-two participants were screened for the presence of C acnes to include 30 participants with the bacterium. Participants with C acnes at baseline were 7.4 years younger than participants without C acnes (P = .015). One participant in the placebo group dropped out before application because of fear of adverse events. After application, C acnes remained present in 3 of 15 participants (20.0%) in the BPO group and in 10 of 14 participants (71.4%) in the placebo group, resulting in a 51.4% reduction in the presence of C acnes. CONCLUSION: Applying BPO 5 times on the shoulder skin effectively reduces C acnes. Consequently, BPO may reduce the risk of postoperative infections.
RCT Entities:
HYPOTHESIS AND BACKGROUND: We hypothesized that benzoyl peroxide (BPO) would reduce the presence of Cutibacterium acnes on the skin of the shoulder by 50% compared with placebo. Infections after shoulder surgery are most commonly caused by C acnes. Current prophylactic methods do not effectively reduce the bacterial load of this bacterium. However, it seems that BPO may reduce C acnes on the skin of the shoulder. Therefore, this study aimed to investigate the effect of BPO on the presence of C acnes on the shoulder skin. METHODS: A double-blinded, randomized, placebo-controlled trial was performed including healthy participants aged between 40 and 80 years. Thirty participants with C acnes on the shoulder skin according to baseline skin swabs were randomized into the BPO or placebo group. After gel application 5 times, skin swabs were taken to determine the presence of C acnes. RESULTS: Forty-two participants were screened for the presence of C acnes to include 30 participants with the bacterium. Participants with C acnes at baseline were 7.4 years younger than participants without C acnes (P = .015). One participant in the placebo group dropped out before application because of fear of adverse events. After application, C acnes remained present in 3 of 15 participants (20.0%) in the BPO group and in 10 of 14 participants (71.4%) in the placebo group, resulting in a 51.4% reduction in the presence of C acnes. CONCLUSION: Applying BPO 5 times on the shoulder skin effectively reduces C acnes. Consequently, BPO may reduce the risk of postoperative infections.