Comparative efficacy and tolerability of fusidic acid/hydrocortisone cream (Fucidin® H cream) and miconazole/hydrocortisone cream (Daktacort® cream) in infected eczema

AbstractAimTo study the efficacy, tolerability and acceptability of 2% fusidic acid and 1% hydrocortisone with 2% miconazole and 1% hydrocortisone.SubjectAtopic dermatitis and topical therapy with antibacterial/antiinflammatory or antifungal/antiinflammatory remedies.MethodsA randomised, open, parallel group comparison.Results207 patients with clinically infected eczema were included in a trial with either 2% fusidic acid and 1% hydrocortisone or 2% miconazole and 1% hydrocortisone. At the end of treatment, there was no statistically significant difference between treatments in the preparations of patients “cleared” or “markedly improved” (fusidic acid 69.5%, miconazole 68.6%).After 1 week treatment, there was a statistically significant difference in the overall treatment response in favour of fusidic acid/hydrocortisone cream (P = 0.04). Fusidic acid/hydrocortisone cream was significantly more effective than miconazole/hydrocortisone cream at 1 week in reducing the total sign score (P = 0.001), erythema (P = 0.002), induration (P = 0.001), dryness/scaling (P = 0.02). and cracking/fissuring (P = 0.01). Fusidic acid/hydrocortisone cream was significantly more effective bacleriologically than miconazole/hydrocortisone cream (P = 0.04), Patients considered that treatment‐related irritation was significantly more common with fusidic acid/hydrocortisone cream (P = 0.03).Adverse events were recorded in 7 (7.3%) patients given fusidic acid/hydrocortisone and in 8 (7.5%) patients given miconazole/hydrocortisone cream and contributed to treatment withdrawal in 1 (1.0%) patient given fusidic acid/hydrocortisone cream and in 3 (2.8%) patients given miconazole/hydrocortisone cream.ConclusionFusidic acid/hydrocortisone cream and miconazole/hydrocortisone cream were equally effective in treating clinically infected eczema. However, fusidic acid/hydrocortisone cream produced a significantly more rapid clinical improvement and was more effective bacteriologically. Both treatments were well tolerated.