The treatment of napkin dermatitis: a double-blind comparison of two steroid-antibiotic combinations.

A double-blind trial was carried out in 62 infants with moderate to severe napkin dermatitis to assess the effectiveness and acceptability of topical treatment with a miconazole/hydrocortisone preparation compared with that of a nystatin/benzalkonium chloride/dimethicone/hydrocortisone preparation. Patients were allocated at random to one or other treatment and the creams were applied to the affected area 3-times daily for 7 days. At the initial visit, a swab was taken for microbiological investigation. Clinical assessments were made of the signs and symptoms of erythema, weeping, tissue maceration and the more general symptom irritability, before and after 7-days' treatment. Parents were asked to note the time taken to significant improvement of their infant's condition and to comment on ease of application and staining properties of the preparation used. Both treatments produced a high and similar overall cure rate (80% and 84%, respectively), with a significant improvement within 48 hours in the majority of cases. Staining of napkins was reported in significantly fewer cases with the miconazole/hydrocortisone cream.