4CPS-032\u2005Skin protection and prevention of cutaneous mycosis

Abstract

Background Skin protectors Dexeryl (D) and Bepanthen (B) contain petroleum derivatives (PD) such as petroleum jelly and paraffin. These substances may favour cutaneous mycosis by triggering an epidermidis pH imbalance and development of fungal infection.1 This observation led our department to limit the use of D and B in favour of calcium hydroxyde liners (L) and care oil (O). In 2016, we initiated a change in practice by providing recommendations, analysis and follow-up of cutaneous topical prescriptions. Purpose The purpose of this study was to determine if there is a correlation between the prescription of PD and the consumption of a topical antifungal, Econazole (E). Material and methods Four-year retrospective analysis of consumption in a geriatrics ward: Skin protector with PD: D, B. Natural skin protector with: L, O. Topical antifungal: E. Comparison of consumption over two periods (period 1: 2014–2015; period 2: 2016–2017) with the Mann–Whitney log rank test. Results Average of mensual consumption, expressed in tubes (T): Period 1: B=117.5T (56; 177), D=52.4T (36; 103), E=79.4T (44; 121), L=2.5T (0; 24), O=171.5T (0; 337). Period 2: B=4.8T (0; 18), D=0.3T (0; 3), E=47.2T (22; 128), L=139.3T (59; 220), O=242T (153; 338). The consumption of B, D, E and L were significantly different between these two periods (p<0.001) Conclusion A change in routine practice led to decreased consumption of B and D in favour of L. This correlated with a significantly decreased c consumption of E. These results are in agreement with those of a case control study that shows that the use of PD promoted an increase in the incidence of systemic candidiasis.1 From now on, B use is limited only to diaper dermatitis resistant to natural skin protectors in order to limit the risk of epidermitis deterioration. A prospective clinical follow-up is ongoing, with physicians from our department, to complete the data. Reference and/or acknowledgements Campbell J, et al. Systemic candidiasis in extremely low birthweight infants receiving topical petrolatum ointment for care: a case control study. Paediatrics 2000. No conflict of interest.