Resistance Trends for S aureus in Atopic Dermatitis

TOPLINE:

Global antimicrobial susceptibility patterns of Staphylococcus aureus in atopic dermatitis (AD) highlight suboptimal effectiveness for several antibiotics, with significant differences between high-income and middle-income countries.

METHODOLOGY:

• To evaluate the antimicrobial susceptibility of S aureus from people with AD, researchers conducted a systematic review and meta-analysis of 61 studies, including 4091 S aureus isolates from individuals with AD up to June 2023.
• Studies included antimicrobial susceptibility for 52 antibiotics.
• Methicillin (pooled together with oxacillin and cefoxitin), erythromycin, fusidic acid, clindamycin, trimethoprim and sulfamethoxazole, vancomycin, and mupirocin were the most frequently reported clinically relevant antibiotics.
• Data from high-income, upper-middle-income, and lower-middle-income countries were included, but none from low-income regions.

TAKEAWAY:

• Optimal antimicrobial susceptibility rates (> 85%) were reported for trimethoprim and sulfamethoxazole, vancomycin, mupirocin, linezolid, doxycycline, daptomycin, and minocycline.
• Antimicrobial susceptibility rates of S aureus to methicillin, erythromycin, fusidic acid, and clindamycin were suboptimal, at 85% or less.
• Significant differences in antimicrobial susceptibility were found between high-income countries and lower-middle-income countries for erythromycin (P = .01), methicillin (P = .04), and trimethoprim-sulfamethoxazole (P = .01).
• Antimicrobial susceptibility patterns did not change significantly over time.

IN PRACTICE:

“In this systematic review and meta-analysis, antimicrobial susceptibility of S aureus to β-lactams, erythromycin, clindamycin, and fusidic acid may be suboptimal for empirical use in individuals with atopic dermatitis,” the authors wrote.

SOURCE:

The study was led by Itzel Guadalupe Elizalde-Jiménez, MD, of the Dermatology Department from Instituto Nacional de Pediatría, Mexico City, Mexico, and was published online on September 25 in JAMA Dermatology.

LIMITATIONS:

The study’s limitations included heterogeneity among the included studies, potential publication bias for several antibiotics, and the lack of data from low-income countries. Additionally, the variability in data collection periods and methods could have affected the generalizability of the findings.

DISCLOSURES:

Maria Teresa García-Romero, MD, MPH, disclosed receiving personal fees from Carnot and L’Oréal and nonfinancial support from L’Oréal. Additional disclosures are noted in the original article.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.