Information for the public

Secondary bacterial infection of eczema and other common skin conditions

3 March 2021

Infected eczema: do I need antibiotics?

Eczema is a skin condition that can make the skin dry, itchy, red, broken and sore. It can also cause blisters and crusting. Eczema can get infected with bacteria, which is also called a secondary bacterial infection. The signs of an infection can include:

  • rapidly worsening eczema (a flare)
  • pus-filled blisters that leak liquid (weep) and crust over
  • no response to eczema treatment such as emollients and corticosteroids
  • a fever (raised temperature)
  • generally feeling unwell.

See your doctor or pharmacist if you’re concerned that you may have a secondary bacterial infection. If you’re generally well, antibiotics are not usually needed. But you may be offered antibiotics (either to apply to the affected area or to take by mouth), for example, because you’re very unwell or at risk of a serious infection because you have an underlying condition.

Using antibiotics when they’re not needed means they might not work as well in the future (that is, become resistant). This is a serious health risk, so NICE has written advice about when to offer antibiotics for some common conditions, including for eczema that has become infected.

Your doctor should explain that antibiotics can cause side effects, such as diarrhoea and nausea (feeling sick).

If an antibiotic is needed for infected eczema, treatment is usually for 5 to 7 days. But the infection is not likely to completely clear up until you have finished your course of antibiotics. Carry on the treatments you usually use on your skin to manage your eczema, whether you’re taking antibiotics or not. See your doctor if:

  • your eczema does not improve after finishing your antibiotics, or suddenly gets worse at any time
  • you feel very unwell.

Your doctor may refer you to hospital if you have signs of a serious illness. If your eczema keeps becoming infected, your doctor might take a swab from your skin for testing to find out which type of antibiotic might work best.

Talk to your local pharmacist or your doctor about other ways to help with symptoms.

Making decisions together

Decisions about treatment and care are best when they are made together. Your health professionals should give you clear information, talk with you about your options and listen carefully to your views and concerns.

If you cannot understand the information you are given, tell your health professional.

Read more about making decisions about your care.

Where can I find out more?

The NHS website has more information about:

These organisations can give you advice and support:

We have also written information on why antibiotics should be used wisely.

We wrote this guideline for people who have been affected by secondary bacterial infection of eczema, and for the staff who treat and support them. All the decisions are based on the best research available.

No evidence was found for other common skin conditions such as psoriasis, chicken pox, shingles and scabies. So, it was not possible to make recommendations for using antibiotics to manage secondary bacterial infection of these other skin conditions. For people with other common skin conditions, your doctor of pharmacist may need to get advice from a specialist about whether you need antibiotics.

ISBN: 978-1-4731-4024-0

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