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Vol. 20, No. 2, 2007
Issue release date: March 2007
Skin Pharmacol Appl Skin Physiol 2007;20:71–76

Antiseptic Efficacy of a Low-Dosed Topical Triclosan/Chlorhexidine Combination Therapy in Atopic Dermatitis

Wohlrab J. · Jost G. · Abeck D.
aDepartment of Dermatology and Venereology, Martin Luther University, Halle, and bSkin Center Harlaching, Munich,Germany; cSpirig Pharma Ltd., Egerkingen, Switzerland

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The topical application of triclosan as an antistaphylogenic antiseptic has proven beneficial in atopic dermatitis. Especially in lipophilic carriers, triclosan is applied in a concentration range between 1 and 5%, usually 2%. However, as a phenol, triclosan is not undisputed and may result in local exacerbation of the disease by eliciting irritative secondary reactions, especially in high concentrations. Chlorhexidine is also an antiseptic which is very effective against Staphylococciand nearly equivalent to triclosan with respect to its antistaphylogenic efficacy. In light of this, the combination of the two active substances in very low concentrations offers a possible option of using the additive effects of the two substances to minimize the risk of side effects. In a uniform W/O emulsion carrier alternatively containing 0.3% triclosan combined with 0.34% chlorhexidine dihydrochloride or 2.0% triclosan, the antibacterial efficacy against Gram-positive skin bacteria could be proven in a preclinical comparison with a reference preparation containing fusidic acid. Subsequently, the pathogen-reducing effect was examined in a clinical study of the influence on clinical severity in patients with atopic dermatitis. Both investigation methods showed that the two test preparations were slightly inferior to the reference preparation, but result in the same degree of pathogen reduction and improvement in the severity of existing atopic dermatitis in direct comparison. The overall results support the conclusion that a combination of triclosan and chlorhexidine in low concentrations as well as the existing antiseptic standard of a 2% triclosan preparation are suitable for pathogen reduction and thus for improving atopic dermatitis.

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Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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