Management of Infectious Aspects of Atopic Dermatitis in Primary Care: A Resident Survey

Atopic dermatitis (AD) is the most common skin disease encountered by pediatric primary care providers. To describe the knowledge, attitudes, and practices of primary care residents in the management of infectious aspects of pediatric AD, an anonymous web-based survey was offered to all residents in the pediatric and family medicine departments at 3 New York City hospitals. Eighty residents responded. Most (62%) reported seeing 5 to 14 patients with AD monthly. Twenty-seven percent reported obtaining cultures prior to prescribing oral antibiotics most of the time, while 8% reported doing so before giving topical antibiotics. Most respondents (60%) reported never/rarely recommending dilute bleach baths, and family medicine residents were significantly more likely to report never doing so (67% vs 16%, P < .001). Greater education on the use of cultures to guide treatment and potential benefits of dilute bleach baths is needed, especially given increasing antibiotic resistance.