Only two RCTs evaluating systemic antibiotics for clinically infected eczema were located.2,7
Oral cefadroxil showed significant benefit over placebo for all clinical and microbiological outcomes.2
Erythromycin acistrate and erythromycin stearate both improved clinical and microbiological outcomes. There was no significant difference between the preparations.7
Two further important RCTs have compared systemic antibiotics with placebo in the treatment of non-clinically infected atopic eczema. In the first,8 oral flucloxacillin 250 mg four times daily for 4 weeks showed no benefit over placebo in terms of clinical efficacy, despite significantly reducing S. aureus counts. The second study9 showed a similar absence of benefit for 2 weeks oral cefuroxime. Rapid recolonisation occurred in both groups after cessation of treatment.
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