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Open Access 01-12-2022 | Contagious Impetigo | Study protocol

Treatment of Impetigo with Antiseptics—Replacing Antibiotics (TIARA) trial: a single blind randomised controlled trial in school health clinics within socioeconomically disadvantaged communities in New Zealand

Authors: Sarah Primhak, Alicia Gataua, Diana Purvis, John M. D. Thompson, Cameron Walker, Emma Best, Alison Leversha

Published in: Trials | Issue 1/2022

Abstract

Background

Impetigo is a common and contagious bacterial skin infection, affecting children worldwide, but it is particularly prevalent in socioeconomically disadvantaged communities. In New Zealand, widespread prescribing of the topical antibiotic fusidic acid had led to an increase in antimicrobial resistance of Staphylococcus aureus. Alternative treatments are urgently being sought, and as impetigo is a superficial infection, it has been suggested that topical antiseptics such as hydrogen peroxide or simple wound care alone may treat impetigo while avoiding the risk of increased antimicrobial resistance.

Methods

This protocol for a non-inferiority, single-blind randomised controlled trial compares topical fusidic acid with topical hydrogen peroxide and with simple wound care in the treatment of childhood impetigo. Participants are randomised to one of the three treatments for 5 days. The primary outcome is clinical improvement assessed through paired photographs analysed by graders blinded to treatment arm. The trial is based in school health clinics in an urban centre in New Zealand. Comparison of antimicrobial resistance patterns pre- and post-treatment is also performed.

Discussion

Special note is made of the need to involve the communities most affected by impetigo in the design and implementation of the clinical trial to recruit the children most in need of safe and effective treatments.

Trial registration

Australian New Zealand Clinical Trials Registry (ANZCTR) 12616000356460. Registered on March 10, 2016

Protocol amendment number: 05

EB and AL contributed equally as senior authors.

Available only for authorised users

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Title: Treatment of Impetigo with Antiseptics—Replacing Antibiotics (TIARA) trial: a single blind randomised controlled trial in school health clinics within socioeconomically disadvantaged communities in New Zealand
Authors: Sarah Primhak
Alicia Gataua
Diana Purvis
John M. D. Thompson
Cameron Walker
Emma Best
Alison Leversha
Publication date: 01-12-2022
Publisher: BioMed Central
Keywords: Contagious Impetigo
Antibiotic
Fusidic Acid
Published in: Trials / Issue 1/2022
Electronic ISSN: 1745-6215
DOI: https://doi.org/10.1186/s13063-022-06042-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Treatment of Impetigo with Antiseptics—Replacing Antibiotics (TIARA) trial: a single blind randomised controlled trial in school health clinics within socioeconomically disadvantaged communities in New Zealand

Abstract

Background

Methods

Discussion

Trial registration

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Discussion

Trial registration

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