Managing bacterial infection

Atopic eczema is frequently complicated by bacterial infection, commonly, Staphylococcus aureus, but infection with Streptococcus pyogenes (group A Streptococcus) may also occur. NICE (2007) recommends oral antibiotics. Flu cloxacillin is active against the common bac terial skin infections and should be the first-line treatment for Staphylococcus aureus and streptococcal infections. Erythromycin should be used if there is local resistance to Flucloxacillin or in children with a penicillin allergy. NICE (2007) recommends that topical antibiotics and combinations of topical corticosteroids and antibiotics should only be used short term, for no longer than 2 weeks on localised areas of skin infection only. Antiseptics are useful adjunct therapies for reducing bacterial load and are added to some emollients, bath oils, soap substitutes and washes and moisturisers. Bacterial resistance is an ongoing issue; NICE (2007) advises that health professionals should be aware and follow local guidelines for advice on patterns of bacterial resistance to antimicrobials.