Antibiotics not always necessary for paediatric atopic dermatitis

There was no significant difference in eczema symptom improvement between children assigned to antibiotics in addition to steroids and emollients and those assigned to placebo, leading researchers to conclude that not all children need antibiotics.

Close up of newborn baby's face with eczema

Antibiotics are frequently prescribed for the treatment of acute flares of atopic dermatitis to help reduce the colonisation of Staphylococcus aureus on the skin. However, questions have been raised over whether this practice has any clinical benefit.

In a study published in the Annals of Family Medicine
[1]
(2017;
15
:
102

104), researchers carried out a randomised trial, assigning 113 children with confirmed non-severely infected eczema to either: oral antibiotic and topical placebo; topical antibiotic and oral placebo; or both oral and topical placebo, in addition to standard treatment with topical steroid and emollient, for one week.

After two weeks, Patient Oriented Eczema Measure scores indicated that symptoms had improved in all three groups and there was no significant difference in scores between the active treatment group and the control group.

The researchers conclude that their findings provide strong evidence that clinically infected eczema responds well to treatment with topical steroids and emollients, and not all children need antibiotics.

References

[1] Francis NA, Ridd MJ, Thomas-Jones E et al. Oral and topical antibiotics for clinically infected eczema in children: a pragmatic randomized controlled trial in ambulatory care. Ann Fam Med 2017; 15: 124-130. doi: 10.1370/afm.2038

Last updated
Citation
Clinical Pharmacist, CP, April 2017, Vol 9, No 4;9(4):DOI:10.1211/PJ.2017.20202480