Anti-staphylococcal treatment in dermatitis.

Question: A 10-year-old boy with atopic dermatitis (AD) came for consultation with an exacerbation. He suffered from pruritus and multiple erythematous skin lesions, identified as inflamed but not infected. Because skin colonization with Staphylococcus aureus is very common in AD and can worsen the skin condition, is it reasonable to add topical antibiotic treatment to the anti-inflammatory treatment in this case?

Answer: Skin colonization with S aureus is prevalent in children and adults with AD, and can aggravate skin inflammation. Although topical combination creams with steroids and antibiotics are widely used for AD flare-ups, their superiority over anti-inflammatory treatment alone is not well established. Antibiotic treatment, whether systemic or topical, should be reserved for cases in which explicit signs of infection are present.