Hill 1998.

Methods	Randomised, parallel‐group design. The study was conducted in a secondary care setting at different dermatology departments in the UK
Participants	120 participants with diagnosis of eczema on one or both hands, and with suspected or confirmed infection Dropouts: 10 Inclusion criteria of the trial Clinical diagnosis of hand eczema with secondary bacterial infection Presence of erythema induration or itching (2 out of 3) 18 years of age or older Exclusion criteria of the trial Psoriasis of the hands Primary cutaneous infections on the hands Non‐eczematous lesions with secondary infection on the hands Topical or systemic antibiotics in previous week Use of other drugs in the past 4 weeks that could affect eczema Known hypersensitivity to study medication Women with inadequate contraception, pregnancy, and breastfeeding Patients unable to comply with the study protocol Study population Gender: 40 female, 18 male Age: mean 35.6 years, range 18 to 79 years
Interventions	Intervention • Betamethasone‐valerate 0.1% + clioquinol 3% cream twice daily for 4 weeks in 57/61 participants • Betamethasone‐v 0.1% + fusidic acid 2% cream twice daily in 53/55 participants for 4 weeks Duration 4 weeks
Outcomes	Primary outcome of the trial Observer‐rated proportion of participants with satisfactory (i.e. good or excellent) response at the last on‐treatment visit based on global rating: excellent, good, fair, or poor Other outcomes Participant‐rated response to treatment: excellent, good, fair, or poor at weeks 1, 2, and 4 Observer‐rated changes in scores for erythema, pruritus, induration, dryness/scaling, cracking/fissuring, clinical signs of infection (for each: 0 = absent, 1 = mild, 2 = moderate, 3 = severe) at weeks 1, 2, and 4 Participant‐rated severity of itching: 0 = absent, 1 = mild, 2 = moderate, 3 = severe at weeks 1, 2, and 4 Participants' assessment of treatment acceptability with regards to stickiness, staining of skin and/or clothing, ease of application, and overall acceptability Bacterial culture at entry and at end of treatment: successful if pretreatment pathogen, if present, was eradicated Adverse events
Notes	Primary outcome assessed at last on‐treatment visit: probably for most participants at week 4, but unclear how much earlier for dropouts (graph suggests after week 4). Not clear if data for secondary outcome number 2 (participant‐rated response) are presented The primary outcome percentage of participants with self‐rated good/excellent control and the secondary outcomes ‐ reduction in severity, investigator‐ and participant‐rated scoring ‐ were included but provided no reproducible data Declarations of interest: one study author was an employee of Leo Pharmaceuticals, Princes Risborourg, UK Funding: the study was designed and sponsored by Leo Pharmaceuticals, Princes Risborough, UK, manufacturer of the study drug Sample size rationale: not stated
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Quote: "treatment was allocated at random" Comment: the article states only that treatment was allocated at random, without further details
Allocation concealment (selection bias)	Unclear risk	No details about how allocation was concealed from participants and clinicians
Blinding of participants and personnel (performance bias) All outcomes	High risk	Quote: "this was a multicentre, prospective, randomized, open‐parallel‐group comparison" Comment: not blinded
Blinding of outcome assessment (detection bias) All outcomes	High risk	Quote: "this was a multicentre, prospective, randomized, open‐parallel‐group comparison" Comment: not blinded, which might have affected observer‐rated outcomes
Incomplete outcome data (attrition bias) All outcomes	Low risk	Quote: "... and were included in an intention‐to‐treat analysis in respect of the primary efficacy criterion only" Comment: intention‐to‐treat analysis
Selective reporting (reporting bias)	Unclear risk	No trial registration found. We did not find major differences between what was stated in the Methods section and in the Results section; however the subscores for clinical signs and symptoms were not given, and it was stated only whether they were statistically significantly different
Other bias	Unclear risk	Baseline comparisons: more 'severe' classification of signs in the betamethasone/fusidic acid group; unclear whether this constitutes a significant difference and was controlled for Diagnostic certainty: yes The study was completed