Clobetasol 17-Propionate Cream as an Effective Preventive Treatment for Drug Induced Superficial Thrombophlebitis

Abstract

Commonly used therapies for thrombophlebitis have a high failure rate. There are scant data on the application  of topical corticosteroids to treat thrombophlebitis. The present study investigated if the potent topical  corticosteroid clobetasol 17-propionate cream (Dermovate, Glaxo Wellcome) can be an effective treatment  for drug-induced thrombophlebitis. 

DP-b99, a neuroprotective agent currently undergoing development for acute stroke, can cause injectionsite  phlebitis. DP-b99 was administered at doses of 1 and 2 mg/kg by a 1 hour intravenous infusion into the  lateral ear vein of groups of 6 and 5 rabbits, respectively. Each rabbit served as its own control by injecting  both ears with DP-b99, while treating only one ear with clobetasol cream immediately after treatment, with  subsequent applications twice daily for 3 days. Phlebitis was evaluated 1, 3, 5, 24, 32, 48, 56 and 72 hours  after DP-b99 treatment using a clinical score ranging from 0 (no reaction) to 4. After 3 days the rabbits were  sacrificed for histological analysis of the ears. 

The phlebitis score was highest at 24 hours. Clobetasol treatment reduced the clinical scores at all time points and shortened the course of phlebitis. Maximal effect was observed 24-48 hours after the first application  of clobetasol cream. Histologically, there were fewer cases of thrombophlebitis in the clobetasoltreated  ears, and those seen were milder and more focal. To the best of the authors’ knowledge this appears  to be the only study to report a phlebitis-ameliorating effect of a topical corticosteroid.