Antibiotics to Manage Bacterial Skin Infections

People with atopic dermatitis (eczema) have a higher risk of infections. This is because eczema damages the skin barrier, which makes it easier for germs to enter and spread. Scratching itchy skin can further damage the skin.^1,2

Infection can worsen eczema symptoms, including blisters, redness, and itching. Skin infections can also cause weeping of the skin. This is where the skin oozes clear or yellow fluid. Infected skin may have red or yellow spots or bumps.^1,3

Antibiotics may be used to treat bacterial skin infections in people with eczema. You should only take antibiotics if a doctor has confirmed that you have a bacterial skin infection. Antibiotics will not help with eczema flares without an infection or if the infection is caused by a virus or fungus. Treating infections quickly can improve health outcomes and eczema symptoms. Taking steps to prevent skin infections is also important. Talk to your doctor if you notice signs of a skin infection.¹

How do antibiotics work?

For people with eczema, infection is usually caused by the bacteria Staphylococcus aureus. It is commonly known as "staph." As many as 90 percent of people with atopic dermatitis carry staph bacteria on their bodies. The damaged skin barrier in people with eczema allows staph to enter the body and multiply. If left untreated, infections can spread throughout the body and become life-threatening.^1,2,4

Antibiotics treat bacterial skin infections by blocking the growth of staph. These drugs may be applied to the skin (topical) or taken by mouth (oral). The choice of antibiotic type depends on the size and number of infected areas. More severe or widespread symptoms may require oral antibiotics.^1,3,5

Examples

Common antibiotics used to treat staph infections in people with eczema include:⁶

• Amoxicillin
• Cephalexin
• Clindamycin
• Doxycycline
• Linezolid
• Trimethoprim-sulfamethoxazole (TMP-SMX)

Some skin infections do not respond to certain antibiotics. This can happen if the infection is caused by a strain that has developed a resistance, such as methicillin-resistant Staphylococcus aureus (MRSA). Your doctor can confirm the strain of bacteria that caused your infection and which antibiotics may be effective in treating it.^1,2

What are the possible side effects?

Side effects can vary depending on the specific drug you are taking. Common side effects of antibiotics are mild and may include:⁷

• Diarrhea
• Nausea and vomiting
• Dizziness
• Rash
• Yeast infections

Some antibiotics may interfere with medicines used to treat eczema. Before taking antibiotics, talk to your doctor about all your medicines.⁷

These are not all the possible side effects of antibiotics. Talk to your doctor about what to expect when taking antibiotics. You should also call your doctor if you have any changes that concern you when taking antibiotics.

Additional treatment options for skin infections

Your doctor can recommend other ways to treat skin infections. For example, bleach baths may help people with moderate to severe eczema who have frequent skin infections. Adding bleach to the bath can reduce the number of bacteria on the skin. Ask your doctor whether this is a good option for you.^1,5

Many people prefer to use a bleach body wash. This may be easier and more convenient than a bleach bath. In 1 study, daily use of a bleach body wash called CLn® improved self-reported symptoms and reduced use of topical corticosteroids.⁴

Another important part of treatment is proper skin care. This can help restore the skin barrier to prevent further staph outbreaks. Skin care also can help reduce how often you need to use antibiotics. This is important to reduce the risk of bacteria becoming resistant to antibiotics.^1,3

Along with routine skin care, try to avoid common eczema triggers like irritants, food allergens, or emotional stress.^1,3

Other things to know

Viruses or fungi also can cause infections in people with eczema. Antibiotics do not work for these infections. Common viral infections are caused by herpes simplex virus and molluscum contagiosum (a poxvirus). They can be treated with antiviral drugs. Common fungal infections are caused by candida (a yeast) and tinea or ringworm (molds). They can be treated with antifungal creams.^1,3

Before beginning treatment for eczema, tell your doctor about all your health conditions and any other drugs, vitamins, or supplements you take. This includes over-the-counter drugs.