Use of Autologous Bacteriotherapy to Treat Staphylococcus aureus in Patients With Atopic Dermatitis: A Randomized Double-blind Clinical Trial.

Teruaki Nakatsuji, Richard L Gallo, Faiza Shafiq, Yun Tong, Kimberly Chun, Anna M Butcher, Joyce Y Cheng, Tissa R Hata

DOI: 10.1001/jamadermatol.2021.1311

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• What is this paper about?

  This study tested if using a patient's own beneficial skin bacteria could help treat their atopic dermatitis. The researchers took good bacteria from patients' healthy skin, grew more of it in the lab, and then applied it back to their skin to see if it would fight harmful Staphylococcus aureus bacteria and improve their eczema symptoms.

• How did the authors study this?

  The researchers conducted a double-blind trial where some patients received their own beneficial bacteria mixed in a cream while others got just the cream alone. They collected bacteria from non-affected skin areas, grew specific strains that could kill S. aureus, and had patients apply the treatment twice daily for 7 days. They tracked bacterial levels on the skin and measured eczema symptoms throughout the study.

• What populations did the authors study?

  The study included 11 adult patients with moderate to severe atopic dermatitis who tested positive for S. aureus on their skin. The group consisted of 4 men and 7 women. All patients had to have specific types of good bacteria on their healthy skin that could fight S. aureus to be included in the study.

• What did the authors find?

  Patients who received their own beneficial bacteria showed a 99.2% reduction in harmful S. aureus bacteria compared to those who got the plain cream. This reduction lasted for 4 days after treatment ended. The treated patients also showed significant improvement in their eczema symptoms, with about 48% reduction in severity scores compared to only 4.5% in the control group.

• What conclusions can we draw?

  The study showed that using a patient's own beneficial skin bacteria appears to be safe and effective at reducing harmful S. aureus and improving eczema symptoms. The authors suggest this could provide an alternative treatment option beyond antibiotics and immunosuppressive drugs, though larger studies are still needed to confirm these findings.