J Drugs Dermatol. 2024 Oct 1;23(10):825-832. doi: 10.36849/JDD.2024.8240.
The skin microbiome is essential for skin barrier function because it inhibits pathogen colonization, and decreased microbiome diversity correlates with increased Staphylococcus aureus (S. aureus) burden and atopic dermatitis (AD) severity. Managing S. aureuss-driven AD in clinical practice remains problematic due to complications such as AD exacerbation, impetigo, abscesses, and invasive infections. This project used a modified Delphi process comprising face-to-face discussions followed by a blinded vote to define 5 final consensus statements. A panel of 6 pediatric dermatologists developed a consensus on S. aureus-driven AD exacerbation, challenges in current treatments for AD with secondary bacterial infections, and new developments to improve patient care and outcomes. The panel's 5 consensus statements provide recommendations for dermatologists, pediatricians, and healthcare providers treating patients with secondary infected AD. These recommendations underscore the importance of recognizing and managing S. aureus skin infection in AD clinical practice and promoting antibiotic stewardship to mitigate resistance. The panel defined a significant unmet need for a single topical AD therapy effective against all symptoms, including pruritus, S. aureus-driven AD exacerbation, infection, and inflammation, across AD severity levels. J Drugs Dermatol. 2024;23(10):825-832. doi:10.36849/JDD.8240.
皮肤微生物组对于皮肤屏障功能至关重要，因为它可以抑制病原体定植，而微生物组多样性的减少与金黄色葡萄球菌（S. aureus）负担的增加和特应性皮炎（AD）的严重程度相关。由于 AD 恶化、脓疱病、脓肿和侵袭性感染等并发症，在临床实践中管理由 S. aureus 驱动的 AD 仍然存在问题。该项目使用了经过修改的 Delphi 流程，包括面对面的讨论和盲目的投票，以确定最终的 5 个共识声明。一个由 6 名儿科皮肤科医生组成的小组就 S. aureus 驱动的 AD 恶化、AD 继发细菌感染的当前治疗挑战以及改善患者护理和结果的新进展达成了共识。该小组的 5 个共识声明为治疗继发感染性 AD 的皮肤科医生、儿科医生和医疗保健提供者提供了建议。这些建议强调了在 AD 临床实践中识别和管理 S. aureus 皮肤感染以及促进抗生素管理以减轻耐药性的重要性。该小组还定义了一个重要的未满足需求，即需要一种有效的单一局部 AD 疗法，能够有效治疗所有症状，包括瘙痒、S. aureus 驱动的 AD 恶化、感染和炎症，且无论 AD 的严重程度如何。J Drugs Dermatol. 2024;23(10):825-832. doi:10.36849/JDD.8240.
