Topical antibiotics in chronic sickle cell leg ulcers - abstract

ABSTRACT

Previous studies have indicated that chronic leg ulcers in homozygous sickle-cell (SS) disease usually contain at least one of the common skin pathogens, Staphylococcus aureus, Pseudomonas aeruginosa or Beta haemolytic streptococci. These organisms are usually sensitve t a mixture of neomycin, bacitracin, and polymyxin B, and a randomised controlled crossover trial of these topical antibiotics has been performed in 30 patients with chronic leg ulcers and SS disease. During the first 8 weeks, the mean ulcer area decreased to 51 percent (SD 34 percent) of initial ulcer size in the treatment group compared to 75 percent (SD 37 percent) in the control group, the difference being significant at the 5 percent level. On crossover, accelerated healing was noted in the group previously receiving control therapy, comparison of the healing rates in the two phases showing a highly significant difference (p<0.005). The results suggest that these topical antibiotics may have a place in the therapy of chronic leg ulceration associated with sickle-cell disease (AU)