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
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.
 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