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When should oral antibiotics be used in the treatment of atopic dermatitis?

Featuring Raj Chovatiya, MD, PhD, MSCI |

Clinical Associate Professor, Rosalind Franklin University Chicago Medical School, Founder and Director, Center for Medical Dermatology and Immunology Research 
Chicago, IL

| Published August 01, 2023


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. 

Key Points 
  • 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.

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