Treatment of atopic dermatitis using topical antifungal drugs: A meta-analysis

Several studies have focused on treating atopic dermatitis (AD) using topical antifungal drugs. However, their findings are inconsistent. This meta-analysis of randomized controlled trials (RCTs) aimed to evaluate the safety and efficacy of topical antifungal drugs for the treatment of AD. We searched prominent databases such as EMBASE, PubMed, Cochrane Library, China Biomedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database (VIP), and Wanfang Database to retrieve all RCTs on the use of topical antifungal drugs for the treatment of AD. The two authors independently performed screening, extraction, and quality evaluation of data based on inclusion and exclusion criteria. In addition, quantitative synthesis and qualitative description of the results were performed using Review Manager 5.3. Nine studies with a total of 785 subjects were included in the meta-analysis. Based on intervention measures, data were divided into three groups: topical antifungal drugs versus placebo, topical antifungal drugs versus topical glucocorticoids, and topical antifungal drugs plus topical glucocorticoids versus topical glucocorticoids. Risk-of-bias assessments revealed that the random distribution methods and allocation concealment were not ideal; further, some studies had incomplete data and reported selective results. Quantitative analysis revealed that in terms of effective rate, topical antifungal drugs are superior to topical glucocorticoids (p = 0.003), and topical antifungal drugs plus topical glucocorticoids are superior to topical glucocorticoids (p = 0.001). However, no significant differences in adverse reactions were observed between the three groups (p > 0.05). The safety and efficacy of topical antifungal drugs for treating AD cannot be accurately evaluated with existing data. Therefore, additional high-quality and large-sample prospective RCTs are required for further validation to determine the appropriateness of topical antifungal drug use for the treatment of AD in clinical settings.