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Guideline review
Secondary bacterial infection of eczema and other common skin conditions: antimicrobial prescribing
  1. Reem Hassan,
  2. Fiona Maccarthy
  1. Ashford and Saint Peter's Hospitals NHS Trust, Chertsey, Surrey, UK
  1. Correspondence to Dr Reem Hassan, Ashford and Saint Peter's Hospitals NHS Trust, Chertsey, Surrey, UK; reemhassan{at}nhs.net

https://doi.org/10.1136/archdischild-2022-324365

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    Background

    Atopic dermatitis, also known as atopic eczema, is the most common chronic inflammatory skin condition in children. The onset of the disease commonly presents by 5 years of age, with approximately 45% of children developing symptoms within the first 6 months of life. The skin of individuals with atopic eczema is more frequently colonised with Staphylococcus aureus bacteria compared with those without eczema,1 making the skin lesions more readily susceptible to infection.

    The management of atopic eczema in children is largely conducted in primary care settings. However, handling flare-ups and addressing secondary bacterial infections can pose a significant challenge for healthcare professionals.

    Information about the current guideline

    The guideline update, NG (190), on secondary bacterial infection of eczema and other common skin conditions: antimicrobial prescribing was published by the National Institute for Health and Care Excellence in March 2021 box 1.2 It has updated and replaced some recommendations on managing bacterial infection in the original guideline (CG 57) for atopic eczema in children under 12, published in 2007. This guideline was developed to aid healthcare professionals in diagnosing and managing eczema in children, with special consideration given to managing infected eczema.3

    Box 1

    Link to guideline

    Secondary bacterial infection of eczema and other common skin conditions: antimicrobial prescribing (https://www.nice.org.uk/guidance/ng190):

    Other resources

    • NICE guideline on atopic eczema in under 12 (CG57)

    https://www.nice.org.uk/Guidance/CG57

    • NICE clinical knowledge summary on atopic eczema

    https://cks.nice.org.uk/topics/eczema-atopic/

    • NICE, National Institute for Health and Care Excellence.

    This current update, NG (190), sets out recommendations on antimicrobial prescribing strategies for secondary bacterial infection of atopic eczema. The overall aim is to optimise antibiotic use and prevent antibiotic resistance. The summary of the guideline focuses on the assessment and management of secondary bacterial infection of atopic eczema in children, with special consideration given to the management of eczema herpeticum. It provides guidance on escalation and specialist reviews.

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    Footnotes

    • Contributors RH: Main author; paediatrics; initiated the review; conducted comprehensive guideline review; drafted and prepared tables; finalised and submitted the review. FM: Supervisor/paediatric consultant; provided guidance and supervision; reviewed and critiqued the manuscript at various stages; offered mentorship to enhance the overall quality of the review.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Commissioned; externally peer reviewed.