Every now and again a new guideline is released that doesn’t look that promising, but really changes the way you look at a topic. A good example of this is the new guideline from NICE on managing the secondary bacterial infection of eczema, published in March.
My first take-home message from this guideline is that even non-infected eczema can be weepy and crusty. My second take-home message is that the evidence shows that there is no benefit from treating with antibiotics, even in eczema that seems to be infected, as long as the patient is well. There is a good visual summary of this guideline.
Are there any diagnostic criteria for infections in eczema?
No. There are no definitive diagnostic criteria for infections in eczema. Even with weeping and crusting, there may well be no infection.
What is the evidence behind treating infections in eczema?
- Most of the available evidence is from children.
- The lack of diagnostic criteria limits the evidence.
- Trials often exclude severe infections or those at higher risk of infection.