A Study of the Effect of Tacrolimus Ointment on the Staphylococcal Colonization in Atopic Dermatitis Patients
BACKGROUND: It is well known that topical tacrolimus is safe and effective on the treatment of atopic dermatitis (AD) patients. Tacrolimus is a primarily immunosuppressive agent without antistaphylococcal effect. Thus the colonization of staphylococcus aureus (S. aureus), on the skin of patients treated with this agent, might be increased. OBJECT: The purpose of this study is to know the effect of tacrolimus on S. aureus colonization of patients with AD and to compare the result with clinical severity and skin barrier function. METHOD: We enrolled 65 patients with moderate to severe AD. They were treated with 0.03% tacrolimus ointment twice daily for 4 weeks. Clinical severity was assessed by the eczema area and severity index (EASI). S. aureus colonization was measured by tape method. Skin barrier function was checked by measuring the transepidermal water loss (TEWL). Evaluations were performed at week 0 (baseline), 1st, 2nd and 4th. The results were compared and the statistical analysis was performed. RESULTS: S. aureus colonization was significantly decreased with tacrolimus treatment at week 1st as compared with baseline. But there were no differences among week 1st, 2nd and 4th. EASI and TEWL showed a decreasing tendency in a time dependent fashion. The correlations between each data were variable. CONCLUSION: Topical application of tacrolimus ointment reduce the colonization of S. aureus on the skin of patients with AD. Moreover, the severity of AD and skin barrier function were improved with treatment. However it is not sure the effect of tacrolimus as a long-term maintenance therapy based on this data, because this is a short term study. In future assessment of topical agents and S. aureus colonization, it will be important to make a study by the comparative method and for a long term period.
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