Oral and Topical Antibiotics for Clinically Infected Eczema in Children: A Pragmatic Randomized Controlled Trial in Ambulatory Care

The Article in Brief

Oral and Topical Antibiotics for Clinically Infected Eczema in Children: A Pragmatic Randomized Controlled Trial in Ambulatory Care

Nick A. Francis , and colleagues

Background This study assesses whether oral or topical antibiotics, in addition to standard treatment with topical corticosteroids, are more effective than placebo in reducing eczema severity in children with clinically infected eczema.

What This Study Found Estimates suggest that 40 percent of eczema flares are treated with topical antibiotics, but findings from this study suggest there is no meaningful benefit from the use of either oral or topical antibiotics for milder clinically infected eczema in children. There was rapid resolution in response to mild-to-moderate strength topical corticosteroids and emollient treatment; clinically meaningful benefit from the addition of either oral or topical antibiotics was ruled out. Because the study excluded patients with severe infection, the results may not be generalizable to all children with clinically infected eczema.

Implications

• The authors conclude that topical antibiotics frequently used in outpatient care, especially in combination products with topical corticosteroids, are not beneficial to patients with clinically infected eczema and can actually promote resistance and allergy or skin sensitization. They suggest that providing or stepping up the potency of topical corticosteroids and emollients should be the main focus in the care of milder clinically infected eczema flares.