Comparative study of the effectiveness of synthetic tannins and aniline dyes in patients with primary or secondary superficial pyoderma

Zaslavsky D.V., Iskra A.S., Iskra E.L., Manylova E.S., Shander E.Z.

St. Petersburg State Pediatric Medical University, Russia
Twenty-first Century Medical Center, St. Petersburg, Russia
St. Petersburg Medical and Social Institute, Russia
Networked clinical center of Family medicine, Moscow, Russia

The pharmacological effects of tannins are mainly related to their astringent action. Several medical studies in recent decades have shown additional antimicrobial and anti- inflammatory properties of tannins.
Purpose of the study. To evaluate the efficacy and safety of fixed tannin combinations, including spray / lotion (suspension) and cream «neotanin» in the treatment of patients with primary or secondary bacterial skin infections. To assess and compare the time frames for clinical resolution of pyoderma during of topical monotherapy with either tannin composition or carbol-fuchsin solution (Castellani paint) or complex therapy with systemic antibacterial drugs.
Material and methods. An open-label comparative clinical study was carried out in an outpatient and inpatient setting. The trial included 50 patients of both sexes, aged 0 to 77 years, with various types of primary or secondary pyoderma. Age composition of patients: 0-1 years old – 2 people (4%), 1-6 years old – 9 subjects (18%), 7-12 years old – 8 subjects (16%), 13-77 years old – 35 subjects (70%). The patients were randomly divided into 4 groups: the first group used tannin preparation (spray, lotion/suspension or cream) as topical monotherapy; the second group used the solution of carbol- fuchsin as topical monotherapy (alcoholic solution or, in patients under 10 years of age, aqueousone); the third group used the combination therapy with tannin preparation (spray, lotion/suspension) or cream) and systemic antibacterial drugs; the fourth group used an alcoholic solution of carbol-fuchsin (in patients under 10 years of age, an aqueous solution) and systemic antibacterial drugs. The patients were followed up for 5-14 days. The criteria for assessing the safety and efficacy of the study drugs were identical in both groups. The effectiveness of these preparations was assessed dynamically assessing subjective complaints of the patient, the presence and severity of clinical symptoms and the affected area.
Results. In the tannin topical therapy group: after a week of use, the severity of pyoderma symptoms decreased by at least 90%. Soreness was absent on the 7th day of using the drugs, itching and burning decreased to 93.2%. By the 7th day of use, excoriation decreased by 80%. The drugs showed a pronounced anti-inflammatory effect – so, on the 7th day of use, symptoms of erythema regressed by 89,8%, manifestation of wetness and edema was absent in 100% of the patients. The area of skin lesions decreased by 73%. The results of microbial culturing confirm the antibacterial activity of tannin preparation against the main and conditionally pathogenic pathogens of skin pyoderma. In the carbol-fuchsin group: in the carbol-fuchsin topical therapy group: after a week of use, the severity of pyoderma symptoms decreased by only 50%. Soreness decreased by only 55% by the 7th day of using carbol-fuchsin, itching decreased by 50%, burning decreased by 60%. By the 7th day of use, excoriation decreased by only 66%. On the 7th day of application, symptoms of erythema regressed by 60%, manifestation of wetness decreased by 84.7%, swelling decreased by 57.9%. The area of skin lesion decreased by only 4%.
Conclusion. Fixed topical compositions with tannins have demonstrated high efficacy and safety in primary and secondary forms of pyoderma in adults and children including infants. Comparative trial of use of modern medical composition based on synthetic tannins with traditional aniline dyes allows us to recommend «neotanin» product line as a more effective topical formulations than carbol-fuchsin (both in monotherapy and in combination with systemic antibacterial drugs).