This Associated Press story looks at results of a small clinical test using a skin cream that contains “friendly” bacteria to fight off potentially harmful bacteria, such as staph, in people with skin conditions like eczema. According to the story, five people received the cream.
While this one day might be a potentially innovative way to treat serious skin infections, it is early research that needed to be contextualized with more detail on the significance of the findings, and the appropriate caveats.
The trial was only designed to test for safety, yet the thrust of the story is about the skin cream’s potential to fight harmful bacteria. One researcher even speculates that this experimental treatment is “boosting the body’s overall immune defenses.”
This leads readers into thinking that the study was more conclusive than it was.
This is preliminary research, but if it’s not too early to speculate about benefits, it’s not too early to discuss costs. Presumably this would be a special, prescription-only lotion, with a higher-than-average price tag compared with normal skin lotion.
We learn that “customized creams guarded five patients with a kind of itchy eczema against risky bacteria that were gathering on their cracked skin” and later, “much of the staph on the treated arms was killed – and in two cases, it was wiped out – compared to the untreated arms,” according to Gallo, the lead researcher.
Is two out of five a proper measure of effectiveness? A bit of skeptical context would have helped explain these benefits.
Moreover, this study, even if taken at face value, does not in any way assure that infections will be prevented, simply that the bad bacteria will be lowered. Sure, the researchers have a theoretical hypothesis that this would translate to fewer infections, but at this point, zero proof.
The story should have explained that the harms are unknown–more testing must be done before a better understanding of the risks and benefits emerge.
As we stated in the harms criterion above, the story did not adequately explain how preliminary this research is, giving readers a sense that it may be farther along than it is. For example, it’s quite a stretch to say that this experimental treatment is “boosting the body’s overall immune defenses,” according to the lead researcher.
The story doesn’t disease monger.
But, it would have been helpful to know how many people might benefit from a cream like this. For example, what percent of people with eczema develop staph infections? Would it be used to treat other active staph infections in people who don’t have an underlying skin disorder? Other types of infections?
The story didn’t disclose this important detail about one of the sources, which was disclosed in the news release on this study:
Teruaki Nakatsuji and Richard L. Gallo are co-inventors of UC San Diego technology related to the bacterial antimicrobial peptides discussed, and Gallo is a cofounder, consultant, chair of the scientific advisory board and holds equity in MatriSys Bioscience, a company that is developing skin bacteriotherapy.
The story gives a tiny mention to the alternative for skin infections–antibiotics. This is a barely passing satisfactory:
“In lab tests and on the surface of animal skin, those substances could selectively kill Staph aureus, and even a drug-resistant strain known as MRSA, without killing neighboring bacteria like regular antibiotics do, the team reported in the journal Science Translational Medicine.”
It’s pretty clear that this idea is still in the experimental stage and hence not available at your local pharmacy. Ideally the story would have explained a bit more about the many steps left in bringing this product to the marketplace (if it ever makes it there; many experimental products never do).
It appears to be a novel approach using one’s own bacteria to treat skin infections, and the article was clear there are other applications of using a person’s own bacteria to develop treatments.
The story included an interview with an independent source, so it didn’t seem to rely on the news release.
Systematic, Criteria-Driven
The tale of two “negative” studies. Or, how spin is applied to make research findings look more impressive. A must read. https://johnmandrola.substack.com/p/the-tale-of-two-negative-studies
The @nytimes chose to interview one of the editors of the @AnnalsofIM (publisher of this paper) who "gushed with extraordinary glee: It’s huge! There are very few things that reduce your mortality by 30%."
Turns out coffee is not one of those few things despite all that glee. https://twitter.com/garyschwitzer/status/1533202075928215558
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