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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