Importance of the field: Atopic eczema is highly colonized with Staphylococcus aureus in lesional as in non-lesional skin. Antimicrobial therapy as part of a comprehensive therapeutic concept in atopic eczema has been discussed for a long a time. Areas covered in this review: A complete literature review of the accessible publications concerning antibacterial and antiseptic therapy has been undertaken. What the reader will gain: This review covers the literature on antimicrobial therapy in atopic eczema and will try to weigh the different publications in the field. Take-home message: A beneficial role for antibacterial/antiseptic therapy on top of anti-inflammatory therapy in atopic eczema has to be questioned. However, a role in prevention of overt skin infection seems possible.