March 14, 2017—Despite widespread use, antibiotics are not an effective treatment for milder cases of the skin condition eczema in children, a new study contends.
One pediatrician who reviewed the findings called them “terribly important” for eczema care.
“This is a good example of a common situation in medicine,” said Michael Grosso, MD. “A particular intervention ‘makes sense,’ becomes common practice — and often becomes the so-called ‘standard of care’—only to be proved ineffective when the therapy is subjected to scientific investigation.”
Grosso is chair of pediatrics at Northwell Health’s Huntington Hospital in Huntington, N.Y.
Eczema is an immunological condition affecting both children and adults, where patches of skin become inflamed, red and itchy.
Craig Osleeb, MD, explained that “children with eczema have an overabundance of the bacteria normally found on skin.” He is a pediatric allergist at Northern Westchester Hospital in Mount Kisco, N.Y.
“The excessive colonization of bacteria can exacerbate symptoms by causing infection and/or triggering inflammation,” Osleeb said. So, “antibiotics have often been used to quell eczema exacerbations.”
But Osleeb noted that the overuse of antibiotics can lead to dangerous drug-resistant “superbug” infections, and prior studies have never settled the issue of whether antibiotics help ease eczema flare-ups.
The new study, led by Nick Francis of Cardiff University in Wales, sought to settle that debate. The study included 113 children with non-severe, infected eczema who were randomly selected to join one of three groups. The children received either an antibiotic pill plus a “dummy” placebo cream; a placebo pill and an antibiotic cream; or placebo pill plus placebo cream (the “control” group).
After watching outcomes for two weeks, four weeks and then three months, the British team found no significant differences between the three groups in terms of easing of eczema symptoms.
According to the researchers, the findings suggest that antibiotics given as either a pill or cream do not benefit children with non-severe infected eczema. The study authors added that such use may even promote antibiotic resistance or additional skin sensitization.
Still, the study focused only on kids with a milder form of eczema, so the results may not apply to children with more severe infected eczema, Francis and colleagues said.
Osleeb agreed. For children battling milder eczema outbreaks, “corticosteroid creams alone will suffice,” he said, but “this study does not eliminate the potential role of antibiotics in more moderate to severe eczema exacerbations.”
The study was published March 13 in the journal Annals of Family Medicine.