Birnie AJ, Bath-Hextall FJ, Ravenscroft JC, Williams HC. Interventions to reduce Staphylococcus aureus in the management of atopic eczema. Cochrane Database of Systematic Reviews. 2008. Issue 3. http://www.mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD003871/frame.html Accessed 23.09.14. RATIONALE: Most RCTs identified by this Cochrane review were of small, of poor quality and heterogeneous. Oral antibiotics were not associated with benefit in two small trials of people with eczema without visible signs of infection (n = 66). Adding antibiotics to topical steroids reduced the numbers of S aureus in 4 trials (n = 302) but not in a further 9 trials (n = 677).
National Collaborating Centre for Women's and Children's Health (2007) Atopic eczema in children: management of atopic eczema in children from birth up to the age of 12 years (full NICE guideline). National Institute for Health and Clinical Excellence. http://guidance.nice.org.uk/CG57 Accessed 23.09.14 RATIONALE: In view of the lack of robust trial evidence, the GDG's view was that flucloxacillin should normally be the first-line treatment for active S aureus and streptococcal infection because it is active against both. Erythromycin or clarithromycin should be used when there is local resistance to flucloxacillin and in children with a penicillin allergy because it is as effective as cephalosporins and less costly. It is the view of the GDG that topical antibiotics, including those combined with topical corticosteroids, should be used to treat localised overt infection only, and for no longer than two weeks.