5% benzoyl peroxide is the most efficient in reducing the cutibacterium flora of the shoulder skin: a network meta-analysis

Purpose: Our study aims to compare different perioperative treatments to reduce C. acnes, the most common causative agent of surgical site infections following shoulder surgery. Methods: A systematic search was performed in MEDLINE (PubMed), Embase, the Cochrane Central Register of Controlled Trials...

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Main Authors: Viktor Weninger, Gergely Agócs, Luca Hergár, Szilárd Váncsa, Bence Hegedűs, Imre Szerb, Péter Hegyi, Gábor Skaliczki
Format: Article
Language:English
Published: Bioscientifica 2025-07-01
Series:EFORT Open Reviews
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Online Access:https://eor.bioscientifica.com/view/journals/eor/10/7/EOR-2024-0160.xml
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author Viktor Weninger
Gergely Agócs
Luca Hergár
Szilárd Váncsa
Bence Hegedűs
Imre Szerb
Péter Hegyi
Gábor Skaliczki
author_facet Viktor Weninger
Gergely Agócs
Luca Hergár
Szilárd Váncsa
Bence Hegedűs
Imre Szerb
Péter Hegyi
Gábor Skaliczki
author_sort Viktor Weninger
collection DOAJ
description Purpose: Our study aims to compare different perioperative treatments to reduce C. acnes, the most common causative agent of surgical site infections following shoulder surgery. Methods: A systematic search was performed in MEDLINE (PubMed), Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), Scopus, and the Web of Science for studies published up to October 20, 2022. We included randomized-controlled trails investigating the efficacy of different dermal preparation in reducing the C. acnes colonising the skin surface. The studies examined positive bacterial cultures before and after skin treatment. The included trials were able to compare seven different skin treatment methods. We performed a frequentist network meta-analysis and calculated pooled risk ratios (RRs) with 95% confidence interval (CI). Results: Our study could include comparisons of 946 different patients. The use of 5% benzoyl peroxide (BPO) and its combination with the antibiotic clindamycin was found to be the most effective in reducing C. acnes colonization on the skin (BPO 5% RR = 0.25, CI: 0.08–0.72, BPO with clindamycin RR = 0.25, CI: 0.04–1.50). Based on the rank plot, 5% BPO (P score: 0.808) was the most effective treatment, followed by BPO 5% with clindamycin (P score: 0.749). We could not perform a network meta-analysis regarding the efficacy of different dermal preparation in reducing C. acnes colonization on the dermis and in the joint. Conclusion: Cutibacterium colonization of the skin flora can be effectively reduced on the skin surface by the use of 5% BPO.
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spelling doaj-art-a0a5437d065742e681fb5ce36d5f5aa42025-08-20T02:44:50ZengBioscientificaEFORT Open Reviews2058-52412025-07-0110754355010.1530/EOR-2024-016015% benzoyl peroxide is the most efficient in reducing the cutibacterium flora of the shoulder skin: a network meta-analysisViktor Weninger0Gergely Agócs1Luca Hergár2Szilárd Váncsa3Bence Hegedűs4Imre Szerb5Péter Hegyi6Gábor Skaliczki7Department of Orthopedic Surgery, Semmelweis University, Budapest, HungaryCentre for Translational Medicine, Semmelweis University, Budapest, HungaryDepartment of Orthopedic Surgery, Semmelweis University, Budapest, HungaryCentre for Translational Medicine, Semmelweis University, Budapest, HungaryDepartment of Orthopedic Surgery, Semmelweis University, Budapest, HungaryInstitute of Pancreatic Diseases, Semmelweis University, Budapest, HungaryCentre for Translational Medicine, Semmelweis University, Budapest, HungaryDepartment of Orthopedic Surgery, Semmelweis University, Budapest, HungaryPurpose: Our study aims to compare different perioperative treatments to reduce C. acnes, the most common causative agent of surgical site infections following shoulder surgery. Methods: A systematic search was performed in MEDLINE (PubMed), Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), Scopus, and the Web of Science for studies published up to October 20, 2022. We included randomized-controlled trails investigating the efficacy of different dermal preparation in reducing the C. acnes colonising the skin surface. The studies examined positive bacterial cultures before and after skin treatment. The included trials were able to compare seven different skin treatment methods. We performed a frequentist network meta-analysis and calculated pooled risk ratios (RRs) with 95% confidence interval (CI). Results: Our study could include comparisons of 946 different patients. The use of 5% benzoyl peroxide (BPO) and its combination with the antibiotic clindamycin was found to be the most effective in reducing C. acnes colonization on the skin (BPO 5% RR = 0.25, CI: 0.08–0.72, BPO with clindamycin RR = 0.25, CI: 0.04–1.50). Based on the rank plot, 5% BPO (P score: 0.808) was the most effective treatment, followed by BPO 5% with clindamycin (P score: 0.749). We could not perform a network meta-analysis regarding the efficacy of different dermal preparation in reducing C. acnes colonization on the dermis and in the joint. Conclusion: Cutibacterium colonization of the skin flora can be effectively reduced on the skin surface by the use of 5% BPO.https://eor.bioscientifica.com/view/journals/eor/10/7/EOR-2024-0160.xmlpropionibacteriumbenzoilhydrogen peroxideperoxideinfectioninfection controlcutibacteriumc. acnes
spellingShingle Viktor Weninger
Gergely Agócs
Luca Hergár
Szilárd Váncsa
Bence Hegedűs
Imre Szerb
Péter Hegyi
Gábor Skaliczki
5% benzoyl peroxide is the most efficient in reducing the cutibacterium flora of the shoulder skin: a network meta-analysis
EFORT Open Reviews
propionibacterium
benzoil
hydrogen peroxide
peroxide
infection
infection control
cutibacterium
c. acnes
title 5% benzoyl peroxide is the most efficient in reducing the cutibacterium flora of the shoulder skin: a network meta-analysis
title_full 5% benzoyl peroxide is the most efficient in reducing the cutibacterium flora of the shoulder skin: a network meta-analysis
title_fullStr 5% benzoyl peroxide is the most efficient in reducing the cutibacterium flora of the shoulder skin: a network meta-analysis
title_full_unstemmed 5% benzoyl peroxide is the most efficient in reducing the cutibacterium flora of the shoulder skin: a network meta-analysis
title_short 5% benzoyl peroxide is the most efficient in reducing the cutibacterium flora of the shoulder skin: a network meta-analysis
title_sort 5 benzoyl peroxide is the most efficient in reducing the cutibacterium flora of the shoulder skin a network meta analysis
topic propionibacterium
benzoil
hydrogen peroxide
peroxide
infection
infection control
cutibacterium
c. acnes
url https://eor.bioscientifica.com/view/journals/eor/10/7/EOR-2024-0160.xml
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