Risk factors and outcomes of secondary bacterial infections among children with atopic dermatitis in a tertiary care setting
DOI:
https://doi.org/10.61529/idjp.v35i1.493Abstract
Background: Atopic dermatitis (AD) typically complicated by secondary bacterial infections, triggered by reduced skin barrier and immune dysregulation. The aim of the study is to evaluate the clinical effects of secondary bacterial infections in children with AD and to identify modifiable and non-modifiable risk factors.
Material and Methods: This cross-sectional analytical study was carried out at Children Hospital and Institute of Child Health Multan between 1st July 2023 and 30th June 2025. Total 420 children with confirmed AD between the ages of 0 and 12 were included. Clinical symptoms, either with or without microbiological evidence, were used to identify secondary bacterial infections. Information was gathered based on treatment history, environmental factors, demographics and AD severity (using SCORAD). Independent predictors of infection were found using univariate and multivariate logistic regression analysis.
Results: Secondary bacterial infection occurred in 193 (46.0%) children. Independent risk factors included severe AD (aOR 3.42), inadequate emollient use (aOR 2.68), prior skin infection (aOR 2.31), and household size >5 (aOR 1.87). Infected children had significantly higher non-responsiveness (31.1% vs. 5.7%), lesion progression, recurrence, and need for IV antibiotics (19.7%) (all p < 0.001).
Conclusion: Secondary bacterial infection is quite prevalent in pediatric AD and is closely linked to the severity of the illness, inadequate skin care, previous infection, and crowding. Infection substantially worsens outcomes, underscoring the need for integrated, infection aware AD management strategies.
Keywords: Atopic dermatitis, Antibiotics, Emollients, Risk factor, Staphylococcus aureus, Skin infection
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