title: The European TREatment of severe Atopic eczema in children Taskforce (TREAT) survey.
abstract: BACKGROUND
  There is a paucity of evidence for the use of systemic agents in children with atopic eczema refractory to conventional therapy, resulting in considerable variation in patient management.
  
  
  OBJECTIVE
  The European TREatment of severe Atopic eczema in children Taskforce (TREAT) survey was established to collect data on current prescribing practice, to identify factors influencing the use of specific systemic agents, and to inform the design of a clinically relevant intervention study.
  
  
  METHODS
  Consultant physician members of the paediatric dermatology societies and interest groups of eight European countries were invited to participate in a web-based survey. The multiple-response format questionnaire collated data on clinical practice in general, as well as detailed information on the use of systemic agents in refractory paediatric atopic eczema.
  
  
  RESULTS
  In total, 343/765 members (44·8%) responded to the invitational emails; 89·2% were dermatologists and 71% initiate systemic immunosuppression for children with severe atopic eczema. The first-line drugs of choice were ciclosporin (43·0%), oral corticosteroids (30·7%) and azathioprine (21·7%). Ciclosporin was also the most commonly used second-line medication (33·6%), with methotrexate ranked as most popular third choice (26·2%). Around half of the respondents (53·7%) replied that they routinely test and treat reservoirs of cutaneous infection prior to starting systemic treatment. Across the eight countries, penicillins were the first-line antibiotic of choice (78·3%).
  
  
  CONCLUSIONS
  In the absence of a clear evidence base, the European TREAT survey confirms the wide variation in prescribing practice of systemic immunosuppression in refractory paediatric atopic eczema. The results will be used to inform the design of a randomized controlled trial relevant to patient management across Europe.
authors.affiliation: St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust, London, SE1 9RT, U.K.
authors.forename: L E
authors.initials: LE
authors.lastname: Proudfoot
authors.forename: A M
authors.initials: AM
authors.lastname: Powell
authors.forename: S
authors.initials: S
authors.lastname: Ayis
authors.forename: S
authors.initials: S
authors.lastname: Barbarot
authors.forename: E
authors.initials: E
authors.lastname: Baselga Torres
authors.forename: M
authors.initials: M
authors.lastname: Deleuran
authors.forename: R
authors.initials: R
authors.lastname: Fölster-Holst
authors.forename: C
authors.initials: C
authors.lastname: Gelmetti
authors.forename: A
authors.initials: A
authors.lastname: Hernández-Martin
authors.forename: M A
authors.initials: MA
authors.lastname: Middelkamp-Hup
authors.forename: A P
authors.initials: AP
authors.lastname: Oranje
authors.forename: K
authors.initials: K
authors.lastname: Logan
authors.forename: M
authors.initials: M
authors.lastname: Perkin
authors.forename: M
authors.initials: M
authors.lastname: Perkins
authors.forename: A
authors.initials: A
authors.lastname: Patrizi
authors.forename: G
authors.initials: G
authors.lastname: Rovatti
authors.forename: O
authors.initials: O
authors.lastname: Schofield
authors.forename: P
authors.initials: P
authors.lastname: Spuls
authors.forename: Å
authors.initials: Å
authors.lastname: Svensson
authors.forename: C
authors.initials: C
authors.lastname: Vestergaard
authors.forename: C-F
authors.initials: CF
authors.lastname: Wahlgren
authors.forename: J
authors.initials: J
authors.lastname: Schmitt
authors.forename: C
authors.initials: C
authors.lastname: Flohr
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D003876:Dermatitis, Atopic / Q000188:drug therapy*; D003879:Dermatologic Agents / Q000627:therapeutic use*; D003880:Dermatology / Q000706:statistics & numerical data*; D005060:Europe; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D013207:Staphylococcal Skin Infections / Q000175:diagnosis / Q000188:drug therapy; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones; D000900:Anti-Bacterial Agents; D003879:Dermatologic Agents; D007166:Immunosuppressive Agents