How can I effectively manage a patient with eczema exacerbated by a secondary infection?

To effectively manage a patient with eczema exacerbated by a secondary infection, first identify signs of bacterial infection such as weeping, pustules, crusts, rapidly worsening eczema, fever, or malaise, and provide clear information on how to access treatment for the infection. Treat the secondary bacterial infection with appropriate systemic antibiotics as per clinical assessment. Advise the patient to obtain new supplies of their topical eczema medications after infection treatment to avoid contamination and reinfection. Continue the use of emollients throughout, as they are the basis of eczema management, and use topical corticosteroids or other anti-inflammatory treatments as indicated by the severity of eczema, stepping treatment up or down accordingly. If the eczema fails to respond to antibiotics and topical corticosteroids, consider the possibility of herpes simplex infection and treat with oral aciclovir if suspected. For widespread herpes simplex (eczema herpeticum), initiate systemic aciclovir immediately and refer urgently for specialist dermatological advice. Maintain education on recognising infection signs and adherence to treatment plans, and consider referral to dermatology if infection treatment fails or eczema remains severe despite optimal therapy.