Infected eczema (Bacterial, mild-moderate)

In people who are not systemically unwell, do not routinely offer either a topical or oral antibiotic for secondary bacterial infection of eczema. Take into account:

• the evidence, which suggests a limited benefit with antibiotics in addition to topical corticosteroids compared with topical corticosteroids alone
• the risk of antimicrobial resistance with repeated courses of antibiotics
• the extent and severity of symptoms or signs
• the risk of developing complications, which is higher in people with underlying conditions such as immunosuppression. 

Do not routinely take a skin swab for microbiological testing in people with secondary bacterial infection of eczema at the initial presentation.

Also prescribe emollient and topical steroids of appropriate potency (see OUH dermatology guideline). Eczema is often undertreated due to use of inappropriately low potency corticosteroids. Topical steroids are required to reduce inflammation especially if secondary infection is suspected.