CD013099

Cochrane Database of Systematic Reviews
Interventions for bacterial folliculitis and boils (furuncles and

carbuncles) (Protocol)
Lin HS, Lin PT, Tsai YS, Wang SH, Chi CC
Lin HS, Lin PT, Tsai YS, Wang SH, Chi CC.
Interventions for bacterial folliculitis and boils (furuncles and carbuncles).
Cochrane Database of Systematic Reviews 2018, Issue 8. Art. No.: CD013099.
DOI: 10.1002/14651858.CD013099.
www.cochranelibrary.com
Interventions for bacterial folliculitis and boils (furuncles and carbuncles) (Protocol)
Copyright © 2018 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
TABLE OF CONTENTS
HEADER . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
ABSTRACT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
BACKGROUND . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
OBJECTIVES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
METHODS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
ACKNOWLEDGEMENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
REFERENCES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
ADDITIONAL TABLES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
APPENDICES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
CONTRIBUTIONS OF AUTHORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
DECLARATIONS OF INTEREST . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
SOURCES OF SUPPORT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Interventions for bacterial folliculitis and boils (furuncles and carbuncles) (Protocol) i
[Intervention Protocol]
Interventions for bacterial folliculitis and boils (furuncles and

carbuncles)
Huang-Shen Lin1 , Pei-Tzu Lin2,3 , Yu-Shiun Tsai4 , Shu-Hui Wang5 ,6 , Ching-Chi Chi7,8
1 Division of Infectious Diseases, Department of Internal Medicine, Chang Gung Memorial Hospital, Chiayi, Chiayi, Taiwan.
2 Department of Pharmacy, Chang Gung Memorial Hospital, Chiayi, Chiayi, Taiwan. 3 Department of Nursing, Chang Gung University
of Science and Technology, Chiayi, Taiwan. 4 Medical Library, Chang Gung Memorial Hospital, Chiayi, Puzih, Taiwan. 5 Department
of Dermatology, Far Eastern Memorial Hospital, New Taipei, Taiwan. 6 Graduate Institute of Applied Science and Engineering, College
of Science and Engineering, Fu Jen Catholic University, New Taipei, Taiwan. 7 College of Medicine, Chang Gung University, Taoyuan,
Taiwan. 8 Department of Dermatology, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
Contact address: Ching-Chi Chi, Department of Dermatology, Chang Gung Memorial Hospital, Linkou, 5, Fuxing St, Guishan Dist,
Taoyuan, 33305, Taiwan. [email protected], [email protected].
Editorial group: Cochrane Skin Group.

Publication status and date: New, published in Issue 8, 2018.
Citation: Lin HS, Lin PT, Tsai YS, Wang SH, Chi CC. Interventions for bacterial folliculitis and boils (furuncles and carbuncles).
Cochrane Database of Systematic Reviews 2018, Issue 8. Art. No.: CD013099. DOI: 10.1002/14651858.CD013099.
ABSTRACT
This is a protocol for a Cochrane Review (Intervention). The objectives are as follows:
To assess the effects of interventions (such as topical antibiotics, topical antiseptic agents, systemic antibiotics, phototherapy, and
incision and drainage) for people with bacterial folliculitis and boils.
BACKGROUND The interest of this Review is bacterial folliculitis, which is a bac-

terial infection within the hair follicle that typically presents as a
red swelling with or without a pustule over the follicular open-
ing (Craft 2012). Without treatment, bacterial folliculitis may re-
Description of the condition
solve in seven to 10 days or may progress to boils; for some cases
Please see Table 1 for explanations of specific terms used in this of folliculitis, especially those caused by Staphylococcus aureus, a
review. course of oral antibiotics may be administered over seven to 10
Folliculitis is inflammation of the hair follicle caused by infection, days (Laureano 2014).
chemical stimulation, or physical injury (Pasternack 2015). The A boil, also known as a furuncle, is a bacterial infection involving
aetiology of folliculitis is diverse, including occlusion folliculitis the perifollicular tissue that usually originates from pre-existing
resulting from blockages caused by exposure to topical products folliculitis (Lopez 2006). A boil appears as a painful red swelling
that block the opening of the hair follicle, leading to inflamma- around the follicular opening and may progress to form an abscess
tion, and Malassezia folliculitis, which is caused by Malassezia fur- (Craft 2012). Some boils may be treated with moist heat applica-
fur (also known as Pityrosporum ovale) and presents as itching red tion; others with surrounding cellulitis or fever may require treat-
papules over the chest, shoulders, or back (Gunatheesan 2018).
Interventions for bacterial folliculitis and boils (furuncles and carbuncles) (Protocol) 1
ment with systemic antibiotics (Pasternack 2015). Systemic an- Local moist heat around 38°C to 40°C applied for 15 to 20 min-
tibiotics should be continued until the lesion resolves (Pasternack utes may increase local blood flow, may establish drainage, and
2015). Carbuncles are large painful swellings with multiple pus- has proved helpful in treatment of newly emerged folliculitis or
discharging openings and constitutional symptoms including fever boils (Pasternack 2015). No adverse effects of local moist heat are
and malaise (Craft 2012). They affect the deeper layers of soft known (Petrofsky 2009).
tissue and can lead to scarring. Without control, boils may occa- Topical antibiotics may be used in treating folliculitis and boils
sionally be complicated by severe skin infections such as cellulitis when the number of lesions is limited, or they may be used in
or lymphadenitis combined with constitutional symptoms such as combination with other interventions, for example, incision and
fever, fatigue, and chills. drainage (Laureano 2014). Available preparations include fusidic
Bacterial folliculitis and boils are prone to occur in areas of the acid 2% cream twice daily (Frosini 2017; Koning 2002), clin-
skin subject to rubbing, occlusion, and sweating, such as neck, damycin 2% gel twice daily, and mupirocin 2% ointment applied
face, axillae, and buttocks (Craft 2012). Clinicians usually diag- two to three times daily (Micromedex 2018). These drugs are top-
nose bacterial folliculitis and boils based on physical examination ically applied over the lesion. Topical antibiotics may cause con-
findings (Craft 2012). tact dermatitis, dryness, or pruritus over the applied area. How-
Bacterial folliculitis and boils are bacterial infections with a world- ever, these adverse events are usually minor (Tran 2017). No major
wide prevalence, but their exact prevalence and incidence are un- drug-drug interactions between these topical antibiotics and other
clear. One study reported a prevalence of around 1.3% in school medications are known (Micromedex 2018).
children (Al-Saeed 2006). Another study found that 27% of im- Topical antiseptic agents may be manufactured as gel (such as ben-
munosuppressed organ transplant recipients presented with per- zoyl peroxide 2% to 10% twice daily), cream, soap, or solution
sistent folliculitis (Lally 2011). In 2010, at least 280,000 boil (e.g. hypochlorite 3% to 5% solution) (Micromedex 2018). These
episodes were reported, and hospital admissions for abscesses, car- antiseptics may be used alone or in combination with antibiotics
buncles, boils, and cellulitis almost doubled in the UK - from for treating folliculitis and boils, especially in recurrent furuncu-
123 admissions per 100,000 in 1998/1999 to 236 admissions per losis (Davido 2013). No specific restrictions apply to the use of
100,000 in 2010/2011 (Shallcross 2015). This rise might have topical antiseptics (Pasternack 2015). The adverse events of ben-
occurred because staphylococcal strains have become more severe zoyl peroxide are usually mild and mainly include skin irritation
or difficult to treat and may cause recurrent infection, as seen with over the application site (Kawashima 2017). No drug interactions
the increased virulence of community-onset methicillin-resistant of topical antiseptics are known (Micromedex 2018).
S aureus (MRSA) produced by toxins such as Panton-Valentine Systemic antibiotics may be used for treating folliculitis and boils,
leukocidin (PVL) (Dufour 2002). especially when systemic symptoms such as fever, lymphadenitis,
Staphylococcus aureus is the most common pathogen of folliculitis or cellulitis appear (Pereira 1996). We have listed regimens and
and boils. However, gram-negative pathogens including Klebsiella, common drug-drug interactions of systemic antibiotics in Table
Enterobacter, and Proteus species may replace the gram-positive 2. First-line oral antibiotics including dicloxacillin (250 mg four
flora on facial skin, nasal mucous membranes, and neighbouring times daily) and cephalosporins (such as cefadroxil 500 mg twice
areas, causing gram-negative folliculitis and boils (Böni 2003). daily) are commonly used. For antibiotic-resistant S aureus that has
’Hot tub’ folliculitis is caused by Pseudomonas aeruginosa contam- emerged in the community, clindamycin, tetracyclines, trimetho-
ination of undertreated water in saunas or whirlpools (Zacherle prim-sulphamethoxazole, linezolid, or glycopeptide, for example,
1982). parenteral vancomycin, may be used (Laureano 2014; Nagaraju
Certain people are affected by recurrent furunculosis (i.e. furuncles 2004). Oral or parenteral ciprofloxacin 400 to 500 mg twice daily
that have a propensity to recur and may spread among family with antipseudomonal activity may be administered for gram-neg-
members) (Ibler 2014). Recurrent boils are a bothersome disorder ative folliculitis such as ’hot tub’ folliculitis (Craft 2012). Potential
that may affect patients’ quality of life (Ibler 2014). Colonisation adverse events of systemic antibiotics include allergic reactions,
of S aureus in the anterior nares plays an important role in the neurological or psychiatric disturbances, and diarrhoea (Shehab
origin of chronic or recurrent furunculosis (Ibler 2014). 2008). Systemic antibiotics may be used in combination with top-
ical antiseptics for treating folliculitis and boils (Pasternack 2015).
Surgical interventions, such as incision and drainage, are likely to
Description of the intervention be adequate for simple fluctuant folliculitis or boils (Ibler 2014).
Incision may cause scarring at the incised site (Ahmad 2017).
Various interventions have been suggested for treating folliculitis
Combination with topical or systemic antibiotics is often em-
(Craft 2012; O’Dell 1998), including local application of moist
ployed, especially with lack of response to incision and drainage
heat, phototherapy, antiseptic agents, antibiotics alone, or com-
alone, or when the lesion is in an area that is difficult to completely
bination therapy. Treatment of fluctuating boils often requires
drain (e.g. face, hands, genitalia) (Ibler 2014).
drainage of the lesion, and for severe infections systemic antibiotics
Phototherapy by monochromatic excimer light (308 nm) with 0.5
should be given until the signs of inflammation have regressed.
to 2 minimal erythema dose (MED) has been used as treatment duct a systematic review to find and evaluate the best evidence on
for superficial folliculitis. Nisticò 2009 reported only mild adverse effects of available interventions for folliculitis and boils.
events such as local erythema.
How the intervention might work

OBJECTIVES
As mentioned above, bacterial folliculitis and boils occur as in-
flammation of the follicle and perifollicular tissue caused by bac- To assess the effects of interventions (such as topical antibiotics,
terial infection. Therefore, antibacterial, antiseptic, and anti-in- topical antiseptic agents, systemic antibiotics, phototherapy, and
flammatory interventions may be used for treatment. incision and drainage) for people with bacterial folliculitis and
Topical antibiotics, for example, clindamycin, aminoglycosides, boils.
and fusidic acid, directly kill or inhibit pathogenic bacteria within
the follicle, avoiding further tissue damage by these pathogens
(Frosini 2017). METHODS
Therapeutic effects of antiseptic agents are attributed to the killing
of bacteria that cause folliculitis and boils, for example, S aureus
(Fisher 2008). Benzoyl peroxide is an antiseptic that confers not
only antibacterial effects but also keratolytic effects, which cause Criteria for considering studies for this review
the skin to dry and peel (Kawashima 2017).
Systemic antibiotics can directly inhibit or kill the pathogenic
bacteria causing folliculitis and boils. When bacterial cultures are
Types of studies
available, systemic antibiotics can be administered according to
the pathogen identified (Ibler 2014). We will include only randomised controlled trials (RCTs), includ-
Ultraviolet-B radiation, primarily affecting the epidermis and the ing parallel, cluster, cross-over, and split-body within-participant
superficial dermis, is absorbed by endogenous chromophobes, RCTs.
such as nuclear DNA, which initiates a cascade of immunomodu-
latory effects (Bulat 2011). For its anti-inflammatory effects, pho-
totherapy has been proposed as a treatment option for folliculitis Types of participants
(Nisticò 2009). Participants will include people with bacterial folliculitis or boils
Given that pus or even an abscess may be present with fluctuant diagnosed by a healthcare professional or a trained researcher based
folliculitis and boils, incision and drainage may be used to remove on clinical presentation or bacterial culture (e.g. via a sensitivity
toxic purulent material, decompress the tissues, and support better test). We will exclude those with non-bacterial folliculitis, for ex-
blood perfusion, which increases drug concentration in an affected ample, Pityrosporum folliculitis and mite folliculitis. We will in-
area and improves local immune response and tissue repair (Ibler clude RCTs conducted in any setting and will include participants
2014). with no restrictions on demographic factors such as age and sex.
When a study includes participants with various superficial bacte-
rial infections of the skin, we will include the study only if study
Why it is important to do this review authors report separate data for those with bacterial folliculitis or
boils. When the publication does not provide separate data, we
The Cochrane Skin Review Group undertook an extensive priori-
will contact study authors and will request separate data for bac-
tisation exercise alongside the Global Burden of Disease and the
terial folliculitis and boils.
World Health Organization to identify a core portfolio of the most
clinically important titles. Consequently, our title was identified
as a clinically important priority by the expert panel for devel-
opment, maintenance, and investment of resources by the edito- Types of interventions
rial base. As aforementioned, folliculitis and boils are worldwide Interventions will include systemic antibiotics, topical antibiotics,
prevalent diseases that cause a great burden on the quality of life topical antiseptics such as topical benzoyl peroxide, photother-
of individuals, with an estimation of 1,944,776 DALYs (disabil- apy, and surgical interventions (e.g. incision and drainage). Par-
ity-adjusted life years) worldwide in 2016 (range, 1,249,848 to ticipants may receive a single intervention or a combination of
2,603,083) (GBD 2018). interventions.
To the best of our knowledge, no systematic reviews to date have Comparators will include another active intervention, placebo, or
examined interventions for folliculitis and boils. We wish to con- no treatment.
Types of outcome measures 2. US National Institutes of Health Ongoing Trials Register (
We will consider outcome data measured at ≤ 1 month and > 1 www.clinicaltrials.gov).
month as short-term and long-term outcomes, respectively. For 3. Australian New Zealand Clinical Trials Registry (
studies with multiple time points, we will consider data from www.anzctr.org.au).
longest follow-up only. 4. World Health Organization International Clinical Trials
Registry Platform ( ICTRP) ( apps.who.int/trialsearch/).
5. EU Clinical Trials Register ( www.clinicaltrialsregister.eu).
Primary outcomes
1. Clinical cure: clearance of all visible lesions of folliculitis or
Searching other resources
boils (i.e. disappearance of all papular or pustular lesions of
folliculitis or boils at the end of treatment)
2. Severe adverse events leading to withdrawal of treatment
Searching reference lists
We will check the bibliographies of included RCTs and any rele-
Secondary outcomes vant systematic reviews identified for further references to relevant
1. Quality of life: as measured by validated tools, including trials.
Dermatology Life Quality Index (DLQI), Short Form-36 (SF-
36), Skindex 29, Skindex 17, or Dermatology Quality of Life
Unpublished literature
Scale (DQOLS)
i) We will consider a DLQI score change of at least 5 as a We will contact the authors of reports of relevant RCTs published
minimally important difference (Khilji 2002) within the last three years to ask if they are aware of any relevant
2. Recurrence of folliculitis or boil following completion of unpublished data.
treatment
3. Minor adverse events not leading to withdrawal of
Adverse effects
treatment
We will not perform a separate search for adverse effects of inter-
ventions used for treatment of folliculitis and boils. We will con-
Search methods for identification of studies sider only adverse events described in included RCTs.
We aim to identify all relevant RCTs regardless of publication lan-

guage or status (published, unpublished, in press, or in progress).
Data collection and analysis
Some parts of this section use text that was originally published
Electronic searches in another Cochrane protocol or in the Cochrane Handbook for
The Cochrane Skin Information Specialist will search the follow- Systematic Reviews of Interventions (Chi 2015; Higgins 2011, re-
ing databases for relevant trials with no restriction by date. spectively).
1. Cochrane Skin Specialised Register.
2. Cochrane Central Register of Controlled Trials
(CENTRAL), in the Cochrane Library. Selection of studies
3. MEDLINE via Ovid (from 1946 onwards). Two review authors (HL and PL) will independently check titles
4. Embase via Ovid (from 1974 onwards). and abstracts derived from the searches. We will not be blinded
The Information Specialist has devised a draft search strategy to the names of trials or their institutions. If we can judge from
for RCTs for MEDLINE (Ovid), which we have displayed in the title and abstract that a study does not relate to an RCT on
Appendix 1. We will use this as the basis for search strategies for interventions for treating folliculitis and boils, we will exclude it
the other databases listed. straight away. The same two review authors will independently ex-
amine the full text of each remaining study and will judge whether
it meets our inclusion criteria. If the two review authors disagree
Trials registers on whether they should include a study, they will achieve una-
We will search the following trials registers using the terms ’boil/s’, nimity through discussion with a third review author (CC). We
’furuncle/s’, ’furunculosis’, ’folliculitis’, ’carbuncle’, ’sycosis’, and will list the studies that we exclude after examining the full text
’sycoses’. and will provide reasons for exclusion in the ’Characteristics of
1. International Standard Randomized Controlled Trials excluded studies’ tables. We will use Covidence for selection of
Number (ISRCTN) register ( www.isrctn.com). studies (Covidence 2017).
Data extraction and management the results).
Two review authors (HL and PL) will independently extract data 3. High risk of bias when at least one domain is judged as
from the included RCTs using a data extraction form to col- being at high risk (plausible bias that seriously weakens
lect the following information: study methods, participants, in- confidence in the results).
terventions, outcomes, country, setting, and funding source (see We will determine the overall risk of bias for each outcome (across
Appendix 2). We have already pilot-tested the data extraction domains) across studies as follows (Higgins 2011).
form. We will use WebPlotDigitizer to extract data from figures 1. Most information is obtained from studies at low risk of
and graphs (WebPlotDigitizer 2017). We will use extracted data bias (plausible bias unlikely to seriously alter the results).
to create the ’Characteristics of included studies’ tables. If we en- 2. Most information is obtained from studies at low or unclear
counter disagreement about some data, the two review authors risk of bias (plausible bias that raises some doubt about the
will consult with a third review author (CC) to achieve unanimity. results).
One review author (PL) will enter the data into Review Manager 3. The proportion of information from studies at high risk of
5 (RevMan 2014), and another review author (HL) will recheck bias is sufficient to affect the interpretation of results (plausible
the entered data. bias that seriously weakens confidence in the results).
Two review authors (HL and PL) will independently assess the
risk of bias of included RCTs. We will discuss with a third review
Assessment of risk of bias in included studies author (CC) to resolve disagreements in assessment.
We will use Cochrane’s tool for assessing risk of bias in RCTs by

evaluating the following domains (Higgins 2011).
1. Random sequence generation (selection bias): adequacy of Measures of treatment effect
the method of random sequence generation to produce
comparable groups in every aspect except for the intervention.
2. Allocation concealment (selection bias): adequacy of the
Dichotomous data
method used to conceal the allocation sequence to prevent
anyone from foreseeing the allocation sequence in advance of, or We will express dichotomous data as risk ratios (RRs) with 95%
during, enrolment. confidence intervals (CIs). When the RR is statistically significant,
3. Blinding of participants and personnel (performance bias): we will also present the number needed to treat for an additional
adequacy of blinding participants and investigators from beneficial outcome (NNTB) and the number needed to treat for
knowledge of which intervention a participant receives. an additional harmful outcome (NNTH) with 95% CIs.
4. Blinding of outcome assessment (detection bias): adequacy
of blinding outcome assessors from knowledge of which
intervention a participant receives. Continuous data
5. Incomplete outcome data (attrition bias): completeness of
We will express continuous data as mean differences (MDs) with
outcome data for each main outcome, including attrition and
95% CIs. When different outcome scales are pooled, we will ex-
exclusions from analysis, whether attrition and exclusions are
press continuous data as standardised mean differences (SMDs)
reported, the numbers in each intervention group (compared
with 95% CIs.
with total randomised participants), reasons for attrition or
exclusions when reported, and any re-inclusions in our analyses.
6. Selective reporting (reporting bias): when the trial protocol
is available, we will determine whether all pre-specified outcomes Time-to-event data
are reported. When the study protocol is unavailable, we will We will express time-to-event data as hazard ratios (HRs) with
identify whether published reports include all expected 95% CIs. We will extract HRs as presented in the included study
outcomes, including those that are pre-specified. report. When HRs were not reported, we will use the methods
7. Other bias: any important concerns about bias not described in Tierney 2007 to estimate the HRs if sufficient data
addressed in the other domains, for example, design-specific risks are provided.
of bias and baseline imbalance.
We will determine the overall risk of bias for each outcome (across
domains) within studies as follows (Higgins 2011).
1. Low risk of bias when all domains are assessed as being at Unit of analysis issues
low risk (plausible bias unlikely to seriously alter the results). We will analyse separately studies of the following types of design
2. Unclear risk of bias when at least one domain is classified as using appropriate techniques as described in the Cochrane Hand-
being at unclear risk (plausible bias that raises some doubt about book for Systematic Reviews of Interventions (Higgins 2011).
Cluster-randomised trials Assessment of heterogeneity
For cluster-randomised trials that have not adjusted for clusters We will calculate the I² statistic to assess statistical heterogeneity
in their analysis, we will employ the Rao methods described in across the included trials. The importance of the observed value of
Chapter 16.3.4 in the Cochrane Handbook for Systematic Reviews of the I² statistic depends on (1) magnitude and direction of effects
Interventions (Higgins 2011; Rao 1992), and we will estimate the and (2) strength of evidence for heterogeneity (e.g. P value from
intervention effect assuming an intracluster correlation coefficient Chi² test, CI for I² statistic) (Higgins 2011). For the confidence
(ICC) of 0.05 . interval for an I² statistic, the rule of thumbs is as follows.
1. 0% to 40%: might not be important.
2. 30% to 60%: may represent moderate heterogeneity.

Cross-over trials 3. 50% to 90%: may represent substantial heterogeneity.
For cross-over trials, we will include only data from the first pe- 4. 75% to 100%: may show considerable heterogeneity.
riod for analysis. If these data are not available, we will employ We will also assess statistical heterogeneity via forest plot inspec-
the statistical methods described in Section 16.4.6 of the Cochrane tion, as in some analyses, a high I² might not be a serious issue,
Handbook for Systematic Reviews of Interventions (Higgins 2011), especially if the estimates are all on the same side of the forest
undertaking paired analyses by imputing missing standard devia- plot. However, we will examine whether statistical heterogeneity
tions. suggests a dose-response relationship or the presence of minimum
therapeutic dose by conducting a subgroup analysis based on dif-
ferent dosages of the intervention.
Studies with multiple treatment groups

Assessment of reporting biases
For studies with multiple intervention groups, we will make sepa-
rate pairwise comparisons of one intervention versus another. For When at least 10 trials are included in a meta-analysis on primary
example, if an RCT includes three interventions groups - Group outcomes for an intervention, we will prepare a funnel plot to
A (placebo or the most frequently used intervention), Group B, assess for publication bias (Higgins 2011).
and Group C - we will make separate pairwise comparisons of B
versus A and C versus A.
Data synthesis
We will provide a narrative description of all outcomes when data
are available. We will pool only trials that are sufficiently similar
Split-body trials
in terms of participants, interventions, and outcomes. We will
For split-body trials, we will conduct paired analyses using data perform a meta-analysis employing the random-effects model to
from one side of the body versus the other side of the body. We obtain a pooled intervention effect. When a meta-analysis is not
will analyse continuous and dichotomous data by using the paired feasible, we will summarise the data narratively instead.
t-test and McNemar’s test, respectively. When results are estimated for individual studies with low num-
bers of outcomes (fewer than 10 in total), or when the total sample
size is less than 30 participants and a RR is used, we will report
the proportion of outcomes in each group together with a P value
Dealing with missing data based on Fisher’s exact test.
We will contact the authors of studies less than 10 years old to The comparisons of interest that we expect for this review include
ask for missing data. When missing data are not available, we will topical antibiotics versus topical antiseptics, topical antibiotics ver-
conduct an intention-to-treat (ITT) analysis to recalculate the in- sus systemic antibiotics, and phototherapy versus sham light.
tervention effect estimates, that is, we will include all randomised
participants in the analysis and will assume that those with miss-
ing dichotomous outcome data experienced treatment failure. For Subgroup analysis and investigation of heterogeneity
missing continuous outcome data, we will attempt to adopt the We will conduct the following subgroup analyses when relevant
last observation carried forward (LOCF) approach in analysis if data are available.
the trials provide relevant original data, that is, we will replace a 1. Paediatric versus adult participants (further divided into
missing value with the participant’s last observed value. Further- bacterial culture-proven or clinical diagnosis only).
more, we will conduct a sensitivity analysis by assuming that those 2. Immunocompetent versus immunosuppressed participants
with missing dichotomous outcome data experienced treatment (further divided into bacterial culture-proven or clinical
success. diagnosis).
3. Methicillin-sensitive S aureus (MSSA) versus MRSA phototherapy versus sham light (see Types of outcome measures).
(including PVL gene type). When several major comparisons are reported, or when outcomes
4. Different dosages of an intervention. need to be summarised for different populations, we will produce
To test for subgroup differences, we will employ random-effects additional ’Summary of findings’ tables.
model analysis and will use the methods developed by Borenstein Two review authors (HL and PL) will assess the quality of the
2008 , which have been implemented in Review Manager software body of evidence using the five Grading of Recommendations
(RevMan 2014). Assessment, Development and Evaluation (GRADE) considera-
tions: study limitations, consistency of effect, imprecision, indi-
rectness, and publication bias (Schünemann 2013). The certainty
Sensitivity analysis (or quality) of evidence can be downgraded from high to moder-
If possible, we will conduct a sensitivity analysis to examine in- ate, low, or very low based on the five considerations stated above.
tervention effects after excluding trials with high risk of bias for We will resolve disagreements by discussion with a third review
one or more domains for the associated outcome. We will also author (CC). We will use GRADEpro GDT (GRADEpro GDT
conduct a sensitivity analysis by assuming that those with missing 2015) to prepare ’Summary of findings’ tables and to assess the
dichotomous outcome data experienced treatment success. certainty of evidence.
’Summary of findings’ tables and GRADE assessments

We will present at least one ’Summary of findings’ table in our re-
view to summarise data on our primary outcomes including clini- ACKNOWLEDGEMENTS
cal cure, severe adverse events leading to withdrawal of treatment,
and secondary outcomes including quality of life, recurrence, and The Cochrane Skin editorial base wishes to thank Sue Jessop,
minor adverse events not leading to withdrawal of treatment for Cochrane Dermatology Editor; Ben Carter, Statistical Editor; the
the most important comparisons: topical antibiotics versus topi- clinical referee, Jeremy Hugh; and Dolores Matthews, who copy-
cal antiseptics, topical antibiotics versus systemic antibiotics, and edited the protocol.
REFERENCES
Additional references Böni 2003

Böni R, Nehrhoff B. Treatment of gram-negative folliculitis
in patients with acne. American Journal of Clinical
Ahmad 2017 Dermatology 2003;4(4):273–6. [PUBMED: 12680804]
Ahmad H, Siddiqui SS. An unusually large carbuncle of Chi 2015
the temporofacial region demonstrating remarkable post- Chi CC, Ko SH, Yeh ML, Wang SH, Tsai YS, Hsu MY.
debridement wound healing process: a case report. Wounds Lifestyle changes for treating psoriasis. Cochrane Database
2017;29(4):92–5. [PUBMED: 28448262] of Systematic Reviews 2015, Issue 11. DOI: 10.1002/
14651858.CD011972
Al-Saeed 2006
Covidence 2017 [Computer program]
Al-Saeed WY, Al-Dawood KM, Bukhari IA, Bahnassy AA.
Veritas Health Innovation. Covidence systematic review
Prevalence and pattern of skin disorders among female
software. Melbourne, Australia: Veritas Health Innovation,
school children in Eastern Saudi Arabia. Saudi Medical
2017.
Journal 2006;27(2):227–34. [PUBMED: 16501682]
Craft 2012
Borenstein 2008 Craft N. Chapter 176. Superficial cutaneous infections
Borenstein M, Hedges LV, Higgins JPT, Rothstein HR. and pyodermas. In: Goldsmith LA, Katz SI, Gilchrest
Introduction to Meta-analysis. Chichester: John Wiley & BA, Paller AS, Leffell DJ, Wolff K editor(s). Fitzpatrick’s
Sons, 2008. Dermatology in General Medicine. Eighth. New York: The
McGraw-Hill Companies, Inc, 2012:2134–2136. [ISBN:
Bulat 2011 978–0–07–171755–7]
Bulat V, Situm M, Dediol I, Ljubici I, Bradi Davido 2013
L. The mechanisms of action of phototherapy in the Davido B, Dinh A, Salomon J, Roux AL, Gosset-
treatment of the most common dermatoses. Collegium Woimant M, Pierre I, et al. Recurrent furunculosis:
Antropologicum 2011;35(Suppl 2):147–51. [PUBMED: efficacy of the CMC regimen - skin disinfection
22220423] (chlorhexidine), local nasal antibiotic (mupirocin), and
systemic antibiotic (clindamycin). Scandinavian Journal of Journal of Dermatology 2001;147(Suppl 62):50. DOI:
Infectious Diseases 2013;45(11):837–41. DOI: 10.3109/ 10.1046/j.1365-2133.147.s62.16.x
00365548.2013.810815 Koning 2002
Dufour 2002 Koning S, van Suijlekom-Smit LW, Nouwen JL, Verduin
Dufour P, Gillet Y, Bes M, Lina G, Vandenesch F, Floret CM, Bernsen RM, Oranje AP, et al. Fusidic acid cream in
D, et al. Community-acquired methicillin-resistant the treatment of impetigo in general practice: double blind
Staphylococcus aureus infections in France: emergence of randomised placebo controlled trial. BMJ 2002;324(7331):
a single clone that produces Panton-Valentine leukocidin. 203–6. [PUBMED: PMC64791]
Clinical Infectious Diseases 2002;35(7):819–24. DOI:
Lally 2011
10.1086/342576
Lally A, Casabonne D, Imko-Walczuk B, Newton R,
Fisher 2008
Wojnarowska F. Prevalence of benign cutaneous disease
Fisher RG, Chain RL, Hair PS, et al. Hypochlorite killing
among Oxford renal transplant recipients. Journal of the
of community-acquired methicillin-resistant Staphyloccus
European Academy of Dermatology and Venereology 2011;25
aureus. Pediatric Infectious Disease Journal 2008;27(10):
(4):462–70. DOI: 10.1111/j.1468-3083.2010.03814.x
934–5. DOI: 10.1097/INF.0b013e318175d871
Frosini 2017 Laureano 2014
Frosini SM, Bond R, Loeffler A, Larner J. Opportunities Laureano AC, Schwartz RA, Cohen PJ. Facial bacterial
for topical antimicrobial therapy: permeation of canine skin infections: folliculitis. Clinics in Dermatology 2014;2(6):
by fusidic acid. BMC Veterinary Research 2017;13(1):345. 711–4. DOI: 10.1016/j.clindermatol.2014.02.009
DOI: 10.1186/s12917-017-1270-6; PUBMED: 29162115 Lopez 2006
GBD 2018 Lopez FA, Lartchenko S. Skin and soft tissue infections.
Institute for Health Metrics and Evaluation. Global Burden Infectious Disease Clinics of North America 2006;20(4):
of Disease (GBD). vizhub.healthdata.org/gbd-compare/ 759–72. DOI: 10.1016/j.idc.2006.09.006
(accessed 18 March 2018). Micromedex 2018
Gilbert 2018 DRUGDEX®. IBM Micromedex® (electronic version).
Gilbert DN, Chambers HF, Eliopoulos GM, Saag MS, www.micromedexsolutions.com/. Greenwood Village:
Pavia AT, editor(s). Sanford Guide to Antimicrobial Therapy. Truven Health Analytics, (accessed 13 June 2018).
8th Edition. Sperryville, VA: Antimicrobial Therapy, Inc.,
Nagaraju 2004
2018.
Nagaraju U, Bhat G, Kuruvila M, Pai GS, Jayalakshmi,
GRADEpro GDT 2015 [Computer program]
Babu RP. Methicillin-resistant Staphylococcus aureus in
McMaster University (developed by Evidence Prime).
community-acquired pyoderma. International Journal
GRADEpro GDT: GRADEpro Guideline Development
of Dermatology 2004;43(6):412–4. DOI: 10.1111/
Tool. Hamilton (ON): McMaster University (developed by
j.1365-4632.2004.02138.x; PUBMED: 15186220
Evidence Prime), 2015.
Gunatheesan 2018 Nisticò 2009
Gunatheesan S. Folliculitis. www.dermcoll.edu.au/atoz/ Nisticò SP, Saraceno R, Carboni I, Chimenti S. Treatment
folliculitis/ (accessed 13 June 2018). of folliculitis with monochromatic excimer light (308
nm). Dermatology 2009;218(1):33–6. DOI: 10.1159/
Higgins 2011
000165627; PUBMED: 18946200
Higgins JPT, Green S (editors). Cochrane Handbook for
Systematic Reviews of Interventions Version 5.1.0 (updated O’Dell 1998
March 2011). The Cochrane Collaboration, 2011. O’Dell ML. Skin and wound infections: an overview.
Available from www.cochrane-handbook.org. American Family Physician 1998;57(10):2424–32.
[PUBMED: 9614412]
Ibler 2014
Ibler KS, Kromann CB. Recurrent furunculosis - challenges Pasternack 2015
and management: a review. Clinical, Cosmetic and Pasternack MS, Swartz MN. Cellulitis, necrotizing fasciitis,
Investigational Dermatology 2014;2014(7):59–64. DOI: and subcutaneous tissue infections. Mandell, Douglas, and
https://doi.org/10.2147/CCID.S35302 Bennett’s Principles and Practice of Infectious Diseases. Eighth.
Vol. 95, St. Louis, MO: Elsevier, 2015:1194–215.
Kawashima 2017
Kawashima M, Nagare T, Doi M. Clinical efficacy and safety Pereira 1996
of benzoyl peroxide for acne vulgaris: comparison between Pereira LC. Comparative clinical study between
Japanese and Western patients. Journal of Dermatology roxithromycin and cephalexin in the treatment of folliculitis,
2017;44(11):1212–8. DOI: 10.1111/1346-8138.13996; furunculosis and erysipelas/cellulitis. Revista Brasileira de
PUBMED: 28791735 Medicina 1996;53(1):81–6.
Khilji 2002 Petrofsky 2009
Khilji FA, Gonzalez M, Finlay AY. Clinical meaning of Petrofsky JS, Bains G, Raju C, Lohman E, Berk L, Prowse
change in Dermatology Life Quality Index scores. British M, et al. The effect of the moisture content of a local heat
source on the blood flow response of the skin. Archives of Clinical Infectious Diseases 2008;47(6):735–43. DOI:
Dermatology Research 2009;301(8):581–5. DOI: 10.1007/ 10.1086/591126; PUBMED: 18694344
s00403-009-0957-3
Tierney 2007
Rao 1992
Tierney JF, Stewart LA, Ghersi D, Burdett S, Sydes MR.
Rao JNK, Scott AJ. A simple method for the analysis of
Practical methods for incorporating summary time-to-event
clustered binary data. Biometrics 1992;48(2):577–85. DOI:
data into meta-analysis. Trials 2007;8:16. DOI: 10.1186/
10.2307/2532311
1745-6215-8-16; PUBMED: 17555582
RevMan 2014 [Computer program]
The Nordic Cochrane Centre, The Cochrane Collaboration. Tran 2017
Review Manager (RevMan) 5.3. Copenhagen: The Nordic Tran K, Wright MD. Topical antibiotics for infected
Cochrane Centre, The Cochrane Collaboration, 2014. dermatitis: a review of the clinical effectiveness and
Schünemann 2013 guidelines (CADTH rapid response report: summary
Schünemann H, Bro ek J, Guyatt G, Oxman A, editors. with critical appraisal). www.cadth.ca/topical-antibiotics-
GRADE Handbook for Grading Quality of Evidence and infected-dermatitis-review-clinical-effectiveness-and-
Strength of Recommendations. The GRADE Working guidelines. Canadian Agency for Drugs and Technologies in
Group, 2013. Health, (accessed 18 March 2018). [PUBMED: 29528606]
Shallcross 2015 WebPlotDigitizer 2017 [Computer program]
Shallcross LJ, Hayward AC, Johnson AM, Petersen I. Ankit Rohatgi. WebPlotDigitizer. Austin, Texas, USA:
Evidence for increasing severity of community-onset Ankit Rohatgi, October 2017.
boils and abscesses in UK general practice. Epidemiology
and Infection 2015;143(11):2426–9. DOI: 10.1017/ Zacherle 1982
S0950268814003458; PUBMED: 25530161 Zacherle BJ, Silver DS. Hot tub folliculitis: a clinical
Shehab 2008 syndrome. Western Journal of Medicine 1982;137(3):191–4.
Shehab N, Patel PR, Srinivasan A, Budnitz DS. Emergency [PUBMED: 7147933]
∗
department visits for antibiotic-associated adverse events. Indicates the major publication for the study
ADDITIONAL TABLES
Table 1. Glossary
Clinical term Explanation
Anterior nares External portion of the nostrils, which opens anteriorly into the nasal cavity and allows air inhalation
and exhalation
Antipseudomonal Agents used as drugs to destroy bacteria of the genus Pseudomonas
Axilla (pl. axillae) Also known as the armpit, underarm, or oxter; the area directly under the joint where the human arm
connects to the shoulder
Cellulitis Term commonly used to indicate non-necrotising inflammation of the skin and subcutaneous tissues,
a process usually related to acute infection that does not involve the fascia or muscles
Endogenous chromophobes A chemical group (such as an azo group) that absorbs light at a specific frequency and so imparts colour
to a molecule that originates from within an organism, tissue, or cell
Epidermis One or more layers of cells forming the outermost portion of the skin or integument
Fluctuant Being movable or compressible; often used to describe a tumour or abscess
Table 1. Glossary (Continued)
Gram-negative bacteria Bacteria that contain an additional outer membrane composed of phospholipids and lipopolysaccha-
rides that do not retain the crystal violet dye in the Gram stain protocol
Immunomodulatory Substance that affects the functioning of the immune system
Keratolytic Causing the horny outer layer of skin to soften and shed
Lymphadenitis Associated with the lymph nodes, which are responsible for fighting off infections of the body; refers to
the condition by which lymph nodes become inflamed, swell, and become tender during an infection
Monochromatic Existing in only one colour or particular wavelength
Perifollicular tissue Tissue surrounding a hair follicle; usually used to describe the histopathological appearance of the
infiltrate surrounding a hair follicle
Pathogen Any small organism, such as a virus or a bacterium, that can cause disease
Pseudomonal Of or related to the Pseudomonas species, which is a ubiquitous strictly aerobic gram-negative bacterium
with a predilection to moist environments and is a clinically significant opportunistic pathogen, often
causing nosocomial infections
Purulent Full of pus or like pus
Superficial dermis Middle layer of skin, deep to the epidermis and superficial to the subcutaneous layer
Table 2. Regimens and drug-drug interactions of systemic antibiotics
Drug Dose/Regimen Drug-Drug interaction (Gilbert 2018;

Micromedex 2018)
Cefadroxil • Adult: 1 g orally daily in a single dose or • Concurrent use of cefadroxil and
in divided doses twice a day warfarin may result in increased risk of
• Pediatric: 30 mg/kg orally once daily or bleeding
in equally divided doses every 12 hours • Concurrent use of cefadroxil and
contraceptives (combination) may result in
decreased contraceptive effectiveness
Ciprofloxacin • Adult: 500 mg orally every 12 hours for • Concurrent use of ciprofloxacin and
7 to 14 days; 400 mg IV every 12 hours for 7 insulin and oral hypoglycaemics may result in
to 14 days increased or decreased blood sugar
• Concurrent use of ciprofloxacin and
caffeine may result in increased caffeine
plasma concentrations
cimetidine may result in increased blood level
of ciprofloxacin
Table 2. Regimens and drug-drug interactions of systemic antibiotics (Continued)

cyclosporine may result in an increased
cyclosporine plasma concentration
didanosine may result in a decreased
ciprofloxacin plasma concentration
cations (e.g. Al3+ , Ca2+ , Fe2+ , Mg2+ , Zn2+ )
(cireate/citric acid) may result in a decreased
plasma concentration of ciprofloxacin
methadone may result in an increased plasma
concentration of methadone
NSAIDs may result in increased risk CNS
stimulation/seizure
phenytoin may result in an increased or
decreased plasma concentration of phenytoin
probenecid may result in a decreased plasma
concentration of ciprofloxacin
rasagiline may result in an increased plasma
concentration of rasagiline
sucralfate may result in decreased absorption
of ciprofloxacin
theophylline may result in an increased
plasma concentration of theophylline
thyroid hormone may result in a decreased
plasma concentration of thyroid hormone
tizanidine may result in an increased plasma
concentration of tizanidine
warfarin may result in increased prothrombin
time
Clindamycin • Adult: 150 to 300 mg orally every 6 • Concurrent use of clindamycin and
hours, 600 to 1200 mg/d IV or IM divided kaolin may result in decreased absorption of
every 6 to 12 hours kaolin
• Pediatric: 8 to 16 mg/kg/d ORALLY • Concurrent use of clindamycin and
divided every 6 to 8 hours; 15 to 20 mg/kg/d muscle relaxants (e.g. atracurium, baclofen,
IV or IM divided every 6 to 8 hours diazepam) may result in increased frequency
and duration of respiratory paralysis
• Concurrent use of clindamycin and St
John’s wort may result in a decreased level of

clindamycin
Tetracyclines • Adult: 500 mg orally twice daily or 250 • Concurrent use of tetracycline and
mg orally 4 times per day atovaquone may result in decreased
• Pediatric: (older than 8 years) 25 to 50 atovaquone levels
mg/kg orally in 4 equally divided doses • Concurrent use of tetracycline and
digoxin may result in increased toxicity of
digoxin
• Concurrent use of tetracycline and
methoxyflurane may result in increased
toxicity, polyuria, and renal failure
sucralfate may result in decreased absorption
of tetracycline
aluminium, bismuth, iron, or Mg2+ may
result in decreased absorption of tetracycline
barbiturates or hydantoins may result in a
decreased serum half-life of tetracycline
carbamazepine may result in a decreased
serum half-life of tetracycline
digoxin may result in an increased serum level
of digoxin
warfarin may result in increased activity of
warfarin
Trimethoprim-sulphamethoxazole • Adult: sulfamethoxazole 800 mg/ • Concurrent use of trimethoprim-

trimethoprim 160 mg to sulfamethoxazole sulphamethoxazole and angiotensin-
1600 mg/trimethoprim 320 mg orally twice converting enzyme inhibitors may result in an
daily increased serum potassium concentration
• Pediatric: (older than 1 month) based on • Concurrent use of trimethoprim-
trimethoprim component: 8 to 12 mg/kg/d sulphamethoxazole and amantadine may
orally in 2 divided doses result in increased serum levels and toxicity of
tetracycline
• Concurrent use of trimethoprim-
sulphamethoxazole and azathioprine may lead
to side effects of leukopaenia
sulphamethoxazole and barbiturates or
hydantoins may result in a decreased serum
half-life of tetracycline
sulphamethoxazole and loperamide may result
in an increased serum level of loperamide

sulphamethoxazole and methotrexate may
result in enhanced marrow suppression
sulphamethoxazole and oral contraceptives,
pimozide, and 6-mercaptopurine may result
in decreased effects of oral contraceptives,
pimozide, and 6-mercaptopurine
sulphamethoxazole and phenytoin may result
in an increased serum level of phenytoin
sulphamethoxazole and rifampin may result
in an increased serum level of phenytoin
sulphamethoxazole and spironolactone or
sulfonylureas may result in an increased serum
potassium level
sulphamethoxazole and warfarin may result in
increased activity of warfarin
Linezolid • Adult: 400 to 600 mg ORALLY every 12 • Concurrent use of linezolid and
hours for 10 to 14 days adrenergic agents may result in increased risk
• Pediatric: (birth through 11 years) 10 of hypertension
mg/kg IV or ORALLY every 12 hours • Concurrent use of linezolid and
clarithromycin may result in an increased
blood concentration of linezolid
• Concurrent use of linezolid and
meperidine may result in increased risk of
serotonin syndrome
rasagiline may result in increased risk of
serotonin syndrome
• Concurrent use of linezolid and rifampin
may result in a decreased serum level of
linezolid
serotonergic drugs may result in increased risk
of serotonin syndrome
Glycopeptide (as vancomycin) Adult: 30 mg/kg/d IV in 2 divided doses or 40 • Concurrent use of vancomycin and
mg/kg/d IV in 4 divided doses aminoglycosides may result in increased
frequency of nephrotoxicity
Al: aluminium; Ca: calcium; CNS: central nervous system; Fe: iron; Mg: magnesium; NSAIDs: non-steroidal anti-inflammatory drugs;
Zn: zinc.
APPENDICES
Appendix 1. Draft MEDLINE (Ovid) search strategy

1. boil$1.ti,ab.
2. Furunculosis/
3. (furuncle$ or furunculos$).ti,ab.
4. Folliculitis/
5. folliculiti$.ti,ab.
6. CARBUNCLE/
7. carbuncle$.ti,ab.
8. (sycosis or sycoses).ti,ab.
9. (hair$1 adj3 follicle$ adj5 (infect$ or swell$ or pus$ or abscess or inflam$)).ti,ab.
10. or/1-9
11. randomized controlled trial.pt.
12. controlled clinical trial.pt.
13. randomized.ab.
14. placebo.ab.
15. clinical trials as topic.sh.
16. randomly.ab.
17. trial.ti.
18. 11 or 12 or 13 or 14 or 15 or 16 or 17
19. exp animals/ not humans.sh.
20. 18 not 19
21. 10 and 20
[Lines 10-19: Cochrane Highly Sensitive Search Strategy for identifying randomized trials in MEDLINE: sensitivity- and precision-
maximizing version (2008 revision)]
Appendix 2. Data extraction form
Study characteristics Data to be extracted Instruction for data extraction
Study ID (Surname of first author and publication year of first full report of study)
Study information Study title Enter the title of the study.
Methods Randomisation methods How is the randomisation sequence generated?
Blinding Are participants, outcome assessors, or providers blinded to which

treatment is given?
Numbers of recruitment locations At how many study sites are participants recruited for the trial?
Participants Inclusion criteria Enter the characteristics that the participants must have in this trial
Exclusion criteria Enter the characteristics that the participants cannot have if enrolled
in this trial
(Continued)
Numbers of participants randomised How many participants were randomised in this trial?
Mean age (years) Enter the mean age ± SD of participants assigned to each group
Sex (% male) Enter the percentage of male participants assigned to each group
Numbers of participants analysed Data from how many participants are analysed in this trial?
Numbers of dropouts How many randomised participants are lost to follow-up during the
study period?
Dropout reasons What are the reasons for participant dropouts?
Interventions Types of interventions Enter the types and methods of interventions, for example, topical
antibiotics, antiseptic agents, systemic antibiotics, phototherapy, or
surgical interventions
Names of medications or methods Enter the names of the interventions, such as the generic name of
drugs
Dosage Enter the dose and frequency for drugs. Enter the duration and
frequency for phototherapy. For surgical intervention, enter ’N/A’
Duration How long do participants receive therapy?
Time point When are the outcomes measured?
Outcomes Primary outcomes Enter data on primary outcomes.
Secondary outcomes Enter data on secondary outcomes.
CONTRIBUTIONS OF AUTHORS
CC was the contact person with the editorial base.
CC co-ordinated the contributions from co-authors and wrote the final draft of the protocol.
HL, PL, YT, and CC worked on the methods sections.
HL and CC drafted the clinical sections of the background and responded to clinical comments of the referees.
CC responded to methodology and statistics comments of the referees.
HL, PL, YT, SW, and CC contributed to writing of the protocol.
SW was the consumer co-author who checked the protocol for readability and clarity. She also ensured that the outcomes are relevant
to consumers.
CC is the guarantor of the final review.
Disclaimer
This project was supported by the National Institute for Health Research, via Cochrane Infrastructure funding to the Cochrane Skin
Group. The views and opinions expressed therein are those of the review authors and do not necessarily reflect those of the Systematic
Reviews Programme, NIHR, NHS, or the Department of Health.
DECLARATIONS OF INTEREST
Ching-Chi Chi: received fees for speaking from AbbVie Taiwan, Ego Pharmaceuticals Taiwan, Janssen-Cilag Taiwan, Novartis Taiwan,
and Pfizer Taiwan.
Huang-Shen Lin: none known.
Pei-Tzu Lin: none known.
Yu-Shiun Tsai: none known.
Shu-Hui Wang: none known.
SOURCES OF SUPPORT
Internal sources
• No sources of support supplied
External sources
• The National Institute for Health Research (NIHR), UK.
The NIHR, UK, is the largest single funder of the Cochrane Skin Group.

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Cochrane Database of Systematic Reviews

Interventions for bacterial folliculitis and boils (furuncles and

Lin HS, Lin PT, Tsai YS, Wang SH, Chi CC

Interventions for bacterial folliculitis and boils (furuncles and

Editorial group: Cochrane Skin Group.

BACKGROUND The interest of this Review is bacterial folliculitis, which is a bac-

How the intervention might work

We aim to identify all relevant RCTs regardless of publication lan-

We will use Cochrane’s tool for assessing risk of bias in RCTs by

2. 30% to 60%: may represent moderate heterogeneity.

Studies with multiple treatment groups

’Summary of findings’ tables and GRADE assessments

Additional references Böni 2003

Clinical term Explanation

Antipseudomonal Agents used as drugs to destroy bacteria of the genus Pseudomonas

Fluctuant Being movable or compressible; often used to describe a tumour or abscess

Immunomodulatory Substance that affects the functioning of the immune system

Monochromatic Existing in only one colour or particular wavelength

Purulent Full of pus or like pus

Table 2. Regimens and drug-drug interactions of systemic antibiotics

Drug Dose/Regimen Drug-Drug interaction (Gilbert 2018;

• Concurrent use of ciprofloxacin and

John’s wort may result in a decreased level of

Trimethoprim-sulphamethoxazole • Adult: sulfamethoxazole 800 mg/ • Concurrent use of trimethoprim-

• Concurrent use of trimethoprim-

Appendix 1. Draft MEDLINE (Ovid) search strategy

Appendix 2. Data extraction form

Study characteristics Data to be extracted Instruction for data extraction

Study information Study title Enter the title of the study.

Methods Randomisation methods How is the randomisation sequence generated?

Blinding Are participants, outcome assessors, or providers blinded to which

Dropout reasons What are the reasons for participant dropouts?

Duration How long do participants receive therapy?

Time point When are the outcomes measured?

Outcomes Primary outcomes Enter data on primary outcomes.

Secondary outcomes Enter data on secondary outcomes.

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