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Antibiotics not effective for clinically infected eczema in children

March 13, 2017

Estimates suggest that 40 percent of eczema flares are treated with topical antibiotics, but findings from this study published in the March/April issue of Annals of Family Medicine suggest there is no meaningful benefit from the use of either oral or topical antibiotics for milder clinically infected eczema in children.

Analyzing data from 113 children with non-severely infected eczema who were randomized to one of three study arms (oral and topical placebos, oral antibiotic and topical placebo, or topical antibiotic and oral placebo), researchers found no significant difference between the three groups in the resolution of eczema symptoms at two weeks, four weeks or three months. They found rapid resolution in response to mild-to-moderate strength topical corticosteroids and emollient treatment, and ruled out a clinically meaningful benefit from the addition of either oral or topical antibiotics.

The authors note that because the study excluded patients with severe infection, the results may not be generalizable to all children with clinically infected eczema.

They conclude that topical antibiotics frequently used in outpatient care, especially in combination products with topical corticosteroids, may not be beneficial to patients with clinically infected eczema and can actually promote resistance and allergy or skin sensitization. They conclude 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.
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Oral and Topical Antibiotics for Clinically Infected Eczema in Children: A Pragmatic Randomized Controlled Trial in Primary Care
By Nick A. Francis
Cardiff University, Wales

Annals of Family Medicine is a peer-reviewed, indexed research journal that provides a cross-disciplinary forum for new, evidence-based information affecting the primary care disciplines. Launched in May 2003, Annals is sponsored by seven family medical organizations, including the American Academy of Family Physicians, the American Board of Family Medicine, the Society of Teachers of Family Medicine, the Association of Departments of Family Medicine, the Association of Family Medicine Residency Directors, the North American Primary Care Research Group, and the College of Family Physicians of Canada. Annals is published six times each year and contains original research from the clinical, biomedical, social and health services areas, as well as contributions on methodology and theory, selected reviews, essays and editorials. Complete editorial content and interactive discussion groups for each published article can be accessed free of charge on the journal's website, http://www.annfammed.org.

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