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GPs urged to avoid prescribing antibiotics for infected eczema

GPs should avoid prescribing oral and topical antibiotics for mildly infected childhood eczema as they have little clinical benefit in clearing infection, researchers have said.

The team from Cardiff University found that antibiotics provided little to no clinical benefit over topical corticosteroids in clearing up mildly infected eczema.

The Children with Eczema, Antibiotic Management (CREAM) study recruited 113 patients, aged between three months and seven years, and assigned them to receive either a topical or an oral antibiotic, along with the corresponding placebo, or two placebos. All three groups were also prescribed a topical corticosteroid and emollients.

The eczema symptom scores in each patient group showed similar levels of improvement over the following weeks, showing that the antibiotics did not play a clinically important role in recovery.

‘Our data provide strong evidence that not all children with clinically infected eczema need to be treated with antibiotics,’ the researchers said.

They added that the use of topical antibiotics may promote antibiotic resistance, allergy and skin sensitisation in eczema patients.

Dr Nick Francis, clinical reader at Cardiff University and a practicing GP, who led the study, said: ‘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.’

Ann Fam Med 2017; available online March 2017

 

Readers' comments (7)

  • And when one of these children develops sepsis and dies (rare, unlikely, statistically insignificant maybe, but it will happen at some point) will Cardiff University be in the dock or the hapless GP who was "only following guidelines"?

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  • Hands off my medical decisions - I'm answerable and have the best interest of my patient in mind.
    Would these guidance churners and 'urgers, coercers and the like take responsibility for anything going wrong? Nope, so please let us use our brains as we do have them if somebody had forgotten.

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  • X.Ray

    Blimey, we are being told you can possibly treat appendicitis now with antibiotics but not infected eczema? What a complicated life we lead.

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  • Spuds

    Hmm. They do seem to work from my own observation. Perhaps more studies required before we chuck 'em out altogether?

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  • ZX81

    ‘Our data provide strong evidence that not all children with clinically infected eczema need to be treated with antibiotics,’
    ...so which ones need antibiotics which ones don't? ...is this one of those 'ignore clinical judgement let hindsight be your guide' bits of well meaning advice? Has it's place I guess, I will keep it in mind, but at the back, behind my judgment.

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  • So I'm supposed to give stronger topical steroids in an infected eczema rash? When a super infection occurs, what's my defence?

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  • well yes,we know infected eczema 'gets better'in immediate terms when you put steroid creams on it-did they watch what happened to infected eczema after they stopped putting the steroids on? Guess I should just read the paper for the details

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