When should oral antibiotics be used in the treatment of atopic dermatitis?
Assistant Professor, Director of Center for Eczema and Itch
Northwestern University Feinberg School of Medicine
A common historical misconception is that oral antibiotics may actually be a helpful monotherapaputic option for patients with atopic dermatitis. Now there is a kernel of truth to this in that we know that infections both cutaneous and systemic can be important comorbidities in patients with atopic dermatitis. Where might an oral antibiotic be useful? Think about that patient, oftentimes quite severe, that has a lot of open areas that are oozing and weeping that have a lot of golden crusting, AKA impetiginization, bacterial colonies that are hanging out right over those open areas of atopic dermatitis. Beyond that, you're typically not going to be thinking about oral antibiotics as a long-term treatment strategy. Really, you should be thinking about more targeted treatment approaches that get at some of the immunopathogenic roots of atopic dermatitis.
In the video, Dr. Raj Chovatiya discusses the use of oral antibiotics in the treatment of atopic dermatitis. He points out that there is a historical misconception that oral antibiotics can be a helpful standalone treatment for atopic dermatitis. While infections, both on the skin and throughout the body, can be significant comorbidities in patients with atopic dermatitis, oral antibiotics should be considered in specific situations.
The appropriate scenario to use oral antibiotics is when dealing with a patient, usually with severe atopic dermatitis, who has a lot of open and oozing areas with golden crusting, also known as impetiginization. In such cases, bacterial colonies are present in those open areas, and oral antibiotics may be useful in managing the infection.
However, beyond this specific context, oral antibiotics should not be considered a long-term treatment strategy for atopic dermatitis. Instead, more targeted treatment approaches that address the immunopathogenic roots of atopic dermatitis should be considered for managing the condition.
- Oral antibiotics are not a recommended monotherapy for atopic dermatitis.
- Oral antibiotics can be useful in cases where the patient has severe atopic dermatitis with oozing, weeping, and golden crusting (impetiginization) in open areas, but not as a long-term treatment strategy for atopic dermatitis.
- Instead, targeted treatment approaches should be considered to address the underlying immunopathogenic factors of atopic dermatitis.