Benzoyl peroxide may reduce presence of C. acnes on the shoulder
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Published results showed use of benzoyl peroxide five times on the skin of the shoulder reduced the presence of Cutibacterium acnes and may reduce the risk of postoperative infections.
Researchers randomly assigned 30 healthy participants identified with C. acnes on the shoulder skin with baseline skin swabs to either a benzoyl peroxide group (BPO Teva hydrogel, Teva Nederland) or a placebo group (Carbomeerwatergel 1% FNA 100 g hydrogel, Fargon NL). Researchers instructed participants to apply the gel five times a day during 2.5 days before collecting another set of skin swabs to determine the presence of C. acnes.
Results showed a 51.4% reduction in the presence of C. acnes, with C. acnes identified in 20% of participants in the benzoyl peroxide group vs. 71.4% of participants in the placebo group after application. Researchers found gram-positive skin flora remained present in 11 of 15 participants in the benzoyl peroxide group and in 13 of 14 participants in the placebo group. After application, two participants in the benzoyl peroxide group and three participants in the placebo group had other bacteria present which were not detected at baseline, according to results.
“This relatively simple and inexpensive intervention can be added to current preventive methods,” the authors wrote. “To determine a reduction in postoperative shoulder infections, more [randomized controlled trials] RCTs with a long follow-up time to measure actual infection reductions in patients applying BPO and undergoing shoulder surgery are required.” – by Casey Tingle
Disclosures: The authors report no relevant financial disclosures.
Perspective
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Andrew Jawa, MD
Floor M. van Diek, MD, and colleagues in their paper, “The presence of Cutibacterium acnes on the skin of the shoulder after the use of benzoyl peroxide: A placebo-controlled, double-blinded, randomized trial” clearly showed that the application of benzoyl peroxide reduced the presence of C. acnes on the skin. The investigation does not show this reduction in bacteria will lead to a lower infection rate after shoulder procedures, but it does set the stage for further investigations examining this question. Interestingly, both benzoyl peroxide and the placebo altered the microbiome of the skin – an observation that has unknown implications for infection rates. Overall, the patient compliance for the use of benzoyl peroxide gel was high and the side effects were mild. This study adds to the growing literature supporting the preoperative use of benzoyl peroxide for surgical shoulder patients; however, large, prospective studies that specifically evaluate the impact of benzoyl peroxide on infection rates as well as side effects need to be performed.
New England Baptist Hospital
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