Use of topical treatment among Swedish children with eczema during the first 18 months of life.

Background

Real-world use of topical therapies in children with eczema during the first 18 months of life is insufficiently characterized. Despite guideline recommendations for regular emollients, population-based data on treatment intensity are limited.

Objectives

To quantify topical treatment use at 18 months, proportion reaching recommended emollient dose, and factors associated with repeated dispensing.

Methods

Data from 18-month-old children (n = 5,275) in the population-based NorthPop Birth Cohort (Västerbotten, Sweden) were analyzed. Atopic dermatitis (AD) was defined using UK Working Party criteria. Eczema severity was assessed with the Patient-Oriented Eczema Measure (POEM). IgE-sensitization was analyzed using ImmunoCAP. Dispensed emollients and topical corticosteroids (TCS) during the first 18 months of life were retrieved from the Swedish Prescribed Drug Register.

Results

AD prevalence was 11.6%, higher in boys than girls (12.6% vs 10.5%, p = 0.037). Only 15.1% of children with AD reached recommended emollient dose (≥100 grams/week) (mean 43.5 g/week). Repeated emollient dispensing occurred in 42.5% (≥2 dispensings) and 14.6% had ≥5 dispensings; 60.8% were dispensed TCS. Male sex and IgE-sensitization, but not eczema severity, were associated with repeated dispensing of emollients and TCS.

Conclusions

In this population-based cohort, topical treatment for early AD was below guideline recommendations, highlighting the importance of caregiver education and structured follow-up.