Paediatric
Infected eczema (Bacterial, severe)
- Take bacterial and viral swabs (for HSV, VZV) prior to starting treatment.
- Patients require isolation until MRSA swab results available. Use standard infection control measures
- Treat for 5-7 days. Review IVs after 24-48 hours.
- 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.
Preferred
Over 1 month: Flucloxacillin 50mg/kg (Max 2g QDS) iv QDS
Alternative
For penicillin allergy (non-severe and severe) or MRSA sensitive to clindamycin
clindamycin 10mg/kg (max 600mg per dose) iv QDS
For other MRSA positive patients:
Oral Stepdown
Refer to Infected eczema (Bacterial, mild-moderate) guideline for antibiotics choice.