Inflamed or Infected Molluscum Contagiosum Lesions: Pediatrician Perceptions and the Risk of Antibiotic Overuse

Area of Science:

• Pediatric Dermatology
• Infectious Diseases
• Microbiology

Background:

• Molluscum contagiosum (MC) is a common viral skin infection in children.
• Inflamed MC lesions can clinically resemble bacterial superinfections, leading to diagnostic uncertainty.
• True bacterial superinfection of MC lesions is considered uncommon.

Purpose of the Study:

• To determine the prevalence of bacterial superinfection in inflamed MC lesions.
• To assess antibiotic prescribing practices for suspected MC superinfections.
• To evaluate pediatricians' diagnostic and treatment approaches to MC superinfection.

Main Methods:

• Retrospective chart review of pediatric MC patients (0-18 years) with bacterial cultures of inflamed lesions over 10 years.
• Analysis of culture results, identified pathogens, and antibiotic usage.
• Survey of general pediatricians regarding their management of suspected MC superinfections.

Main Results:

• Only 12% of bacterial cultures from inflamed MC lesions yielded pathogenic organisms.
• Despite low culture positivity, 71% of patients received topical and 63% received systemic antibiotics.
• 47% of surveyed pediatricians reported never culturing MC lesions with suspected superinfection.

Conclusions:

• The study confirms a low prevalence of bacterial superinfection in MC lesions.
• Antibiotics are often prescribed empirically for MC lesions, even with negative cultures.
• Implementing bacterial cultures and awaiting results could reduce unnecessary antibiotic prescriptions for MC.