Caring for Patients with Bed Bug Bites

Key points

  • Most bed bug bites require only minimal symptomatic treatment and good hygiene to prevent secondary infection.
  • If needed, use topical steroid creams for severe cases.
  • Secondary infections may require antibiotics.

Treatment recommendations

Minimal symptomatic treatment to prevent itching is usually sufficient treatment for most cases of bed bug bites. Avoiding scratching the bites, and good hygiene, are important to avoid secondary infections.

A wide range of empirical treatments, including antibiotics, antihistamines, topical and oral corticosteroids, and epinephrine have been used for bites and their sequelae with varying results. Treatment options for cutaneous and systemic reactions from bed bug bites have not been evaluated in clinical trials. There is no evidence that outcomes differ significantly from those receiving no treatment.

In more extensive or severe bite reactions, topical steroid creams with or without systemic anti-H1 receptor antihistaminics may be helpful in controlling symptoms. Topical or systemic antibiotics may be needed in the case of secondary infection.1234

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