Prevalence of Contact Allergy to Neomycin in Dermatitis Patients: A Systematic Review and Meta-Analysis

Neomycin, an aminoglycoside antibiotic frequently employed in topical formulations, is a recognised allergen that is part of many baseline series and can cause contact allergy (CA) in both adults and children. It is an allergen of interest as it has a widespread use in over-the-counter and prescription products globally, but geographical variations may exist. This study aimed to establish prevalence estimates of CA to neomycin in dermatitis patients and to investigate potential geographical variations. Three databases (PubMed, Embase, and Web of Science) were screened, revealing 70 included studies comprising 456 372 adults and 17 720 children who underwent patch testing. The pooled prevalence of CA to neomycin was found to be 3.2% (95% confidence interval [CI]: 2.6%-3.8%) in adults and 4.3% (95% CI: 2.65%-6.3%) in children. The highest prevalences were observed in North America (adults: 6.4%; children: 8.1%) and South Asia (adults: 4.9%), while Europe showed lower rates (adults: 2.5%; children: 0.8%). Studies after the year 2000 indicated a prevalence of 2.1% in adults and 5.1% in children across geographical regions. These findings highlight a public health concern, particularly in regions with high prevalence rates. The study underscores the need for more restrictive use of neomycin to reduce the incidence of neomycin-induced CA.