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Management of Infected, Non-Responsive Atopic Dermatitis in a Romanian Center.

Raluca-Gabriela Miulescu1,2, Ioana Roșca1,3, Alexandru-Neculai Pavel4,5

  • 1Faculty of Medicine, "Carol Davila" University of Medicine and Pharmacy, 020021 Bucharest, Romania.

Journal of Clinical Medicine
|July 15, 2026
PubMed
Summary

Individualized treatment significantly improved pediatric atopic dermatitis symptoms and severity in a 30-day study. Baseline disease severity, not Staphylococcus aureus colonization, was the key predictor of outcomes in children with infected lesions.

Keywords:
Staphylococcus aureusatopic dermatitis in pediatric patientsfood allergiesmicrobiotaskin dysbiosis

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Area of Science:

  • Pediatric Dermatology
  • Microbiology
  • Clinical Research

Background:

  • Atopic dermatitis (AD) in children is a chronic inflammatory skin condition linked to skin barrier issues, immune problems, and microbial imbalance.
  • Infected, treatment-resistant AD lesions, often involving Staphylococcus aureus, can worsen disease severity and complicate management.
  • Understanding the microbiological profile and treatment response is crucial for managing severe pediatric AD.

Purpose of the Study:

  • To analyze the microbial makeup of infected, non-responsive pediatric atopic dermatitis.
  • To assess short-term clinical outcomes after tailored treatment interventions.
  • To identify factors predicting disease severity in this patient group.

Main Methods:

  • Observational study of 41 children with infected, treatment-resistant AD.
  • Skin cultures for antibiogram/antifungigram; disease severity assessed via POEM and SCORAD at baseline, 7, and 30 days.
  • Statistical analysis included repeated-measures ANOVA, mixed ANOVA, and hierarchical linear regression.

Main Results:

  • Staphylococcus aureus was the most common pathogen identified.
  • Both POEM and SCORAD scores showed significant improvement by day 30, with early gains by day 7.
  • Baseline disease severity was the strongest predictor of outcomes; S. aureus colonization and systemic therapy did not significantly impact improvement trajectory.

Conclusions:

  • Individualized management led to significant clinical and patient-reported improvements in pediatric AD over 30 days.
  • Methicillin-sensitive Staphylococcus aureus (MSSA) was the predominant isolate.
  • Initial disease severity is the primary predictor of short-term outcomes in this cohort, highlighting the need for baseline assessment.