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Eczema is a debilitating skin condition that is especially common in young children. People with eczema frequently have a bacteria called Staphylococcus aureus (S. aureus) on their skin. Many doctors believe that infection with these bacteria can make eczema worse, however studies so far have been inconclusive and mostly of poor quality. So we do not know whether patients with eczema, which a GP or nurse suspects is infected, will benefit from treatment with antibiotics. Furthermore, it is not known whether taking an antibiotic by mouth (oral) or using an antibiotic cream on the skin (topical) is more effective and/or cause least harm.

Study Design

CREAM is a 3-arm, double-blind, randomised controlled trial to determine the clinical and cost effectiveness of the most commonly used oral and topical antibiotics, in addition to topical corticosteroids, in the management of suspected infected atopic eczema in children.


CREAM will be a three-year study, starting in 2012. There will be a six-month set-up phase, one year of patient recruitment, one year of participant follow-up, and six months for completion of analyses and dissemination.


The CREAM Study is funded by the Department of Health's National Institute for Health Research Health Technology Assessment Programme.


The main aim of the CREAM study is to assess whether oral or topical antibiotic treatment (in addition to treatment with corticosteroid cream) reduces subjective eczema severity in children with suspected infected eczema in primary care.

Secondary objectives include assessing the effectiveness of oral and topical antibiotics on objective eczema severity, quality of life, impact on the family, and daily symptoms; comparing oral and topical antibiotic treatment; assessing and describing the clinical features associated with infection in these children; and describing the prevalence and resistance patterns of S. aureus isolates in these children, and the long-term effects of each treatment on colonisation and infection with resistant organisms.


For more information on the CREAM study at Tayside CRF please email