Meta-Research Study on the Quality of Randomized Controlled Trials Evaluating Drug Therapy for Impetigo

Impetigo is a common, highly contagious bacterial skin infection primarily affecting children. Treatment usually involves topical or oral antibiotics, and numerous clinical trials have been published to support these therapeutic approaches.

To evaluate the methodological quality of randomized clinical trials (RCTs) on the pharmacological treatment of impetigo in children and adolescents.

This meta-research evaluated RCTs on systemic or topical pharmacological treatments for impetigo in children and adolescents. A comprehensive literature search was conducted in September 2024 across MEDLINE, Embase, CENTRAL, and LILACS databases. The methodological quality of the included RCTs was assessed using the Cochrane Risk of Bias tool. Data are presented as percentages.

Twenty-one RCTs on pharmacological treatments for impetigo were identified and assessed. The findings identified some methodological concerns: i) 53% to 57% of RCTs had an unclear risk of selection bias due to insufficient information on randomization and allocation concealment; ii) 71% were at high risk of bias for blinding of participants and personnel, while 57% had a high risk for blinding of outcome assessors; iii) 24% exhibited a high risk of attrition bias due to significant participant losses without justification; iv) 81% had an unclear risk of bias due to the lack of registered protocols available.

Based on the methodological quality of the assessed RCTs, this study highlights the need for more rigorous design and reporting standards in future research on pharmacological treatments for impetigo to enhance the reliability and validity of the evidence, thereby supporting more informed clinical decision-making.