Should Chinese herbal medicines be used in patients with skin and soft-tissue infections?

What are skin and soft-tissue infections?
Skin and soft-tissue infections (SSTIs) are common infections of the skin or the tissue beneath the skin. They include impetigo, abscesses, cellulitis, erysipelas, necrotising (flesh-killing) skin infections, infections caused by animal or human bites or by animal contact, and infections after surgery.

Most SSTIs do not require treatment, but heal by themselves. Some SSTIs are more serious and can become life-threatening, and these need medical treatment.

What are Chinese herbal medicines?
Chinese herbal medicines are mostly extracts of plants, or parts of plants, that are used individually, or combined, as medicines. These traditional medicines have been used in China for centuries, and Chinese doctors currently prescribe them to treat SSTIs.

Why use Chinese herbal medicines for SSTIs?
In the Western world antibiotics are used to treat SSTIs, however antibiotics are expensive, can cause harms (side effects) as well as benefits, are not suitable for all people, and are becoming less effective as bacteria start to develop resistance to them. Alternative treatments need to be identified, and Chinese herbal medicines could provide that alternative.

The purpose of this review
The aim of this review was to see if medical research showed whether Chinese herbal medicines are an effective treatment for SSTIs. We wanted to compare the use of Chinese herbal medicines with other treatments, or a fake treatment (placebo), to see which produced a better outcome for patients in a particular type of medical study called a 'randomised controlled trial'.

Findings of this review
We could not find any randomised controlled trials that compared the use of Chinese herbal medicines for treating SSTIs with other treatments or a placebo. Therefore, we cannot support or refute the use of Chinese herbal medicines to treat SSTIs.

In future, we hope that randomised controlled trials will be conducted to evaluate the benefits and side effects of Chinese herbal medicines compared with current practice for the treatment of SSTIs. These trials would help people and doctors to decide on the best way to treatment SSTIs.

Authors' conclusions: 

There is currently no information available from RCTs to support or refute the use of Chinese herbal medicines in treating people with SSTIs.

Read the full abstract...
Background: 

Skin and soft-tissue infections (SSTIs) are common infections of the epidermis, dermis or subcutaneous tissue. SSTIs range in severity from minor, self-limiting, superficial infections to deep, aggressive, gangrenous, life-threatening infections. Some classifications divide SSTIs into 'complicated' and 'uncomplicated' infections based on clinical severity. Treatments of SSTIs involves antibiotic therapy, surgical debridement or drainage, and resuscitation if required. Sometimes these treatments are limited by high treatment costs, bacterial resistance to antibiotics and side effects, therefore, many people with SSTIs are turning to Chinese herbal medicines to treat this problem.

Chinese herbal medicines are natural substances that have been used for centuries in China where they are generally considered to be effective for SSTIs. Some Chinese herbal medicines have been shown to have antibacterial and anti-inflammatory properties, although a few herbal medicines have been reported to have side effects. Therefore there is a need to review the current clinical evidence systematically to inform current practice and guide future studies on Chinese herbal medicines for SSTIs.

Objectives: 

To evaluate the benefits and harms of Chinese herbal medicines for treating skin and soft-tissue infections (SSTIs).

Search strategy: 

Searches were not restricted by date, language or publication status. In July 2014 we searched the following electronic databases: the Cochrane Wounds Group Specialised Register; the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library); Ovid MEDLINE; Ovid MEDLINE (In-Process & Other Non-Indexed Citations); Ovid EMBASE; Ovid AMED (Allied and Complementary Medicine); and EBSCO CINAHL.

Selection criteria: 

All randomised controlled trials (RCTs) in people with SSTIs that compared Chinese herbal medicines with another intervention or control.

Data collection and analysis: 

Two review authors screened the literature search results independently; there were no disagreements.

Main results: 

We identified no RCTs that met the inclusion criteria.

Share/Save