From the Guidelines
Cefixime is not the preferred treatment for impetigo due to its limited coverage against Staphylococcus aureus, a common cause of the infection. According to the 2014 practice guidelines for the diagnosis and management of skin and soft tissue infections by the Infectious Diseases Society of America 1, the recommended oral antibiotics for impetigo are dicloxacillin or cephalexin, which are effective against S. aureus.
- Key points to consider in the treatment of impetigo include:
- The use of oral or topical antimicrobials, with oral therapy recommended for patients with numerous lesions or in outbreaks affecting several people 1
- Treatment with either topical mupirocin or retapamulin twice daily for 5 days for bullous and nonbullous impetigo 1
- Oral therapy for ecthyma or impetigo should be a 7-day regimen with an agent active against S. aureus, such as dicloxacillin or cephalexin 1
- Cefixime's spectrum of activity is more directed toward gram-negative organisms, making it less suitable for impetigo management compared to other available antibiotics.
- The guidelines recommend considering the susceptibility of the causative organism, with MRSA suspected or confirmed cases requiring alternative treatments such as doxycycline, clindamycin, or sulfamethoxazole-trimethoprim (SMX-TMP) 1.
From the Research
Cefixime for Impetigo
- Cefixime is not mentioned as a treatment option for impetigo in the provided studies 2, 3, 4, 5, 6.
- The studies suggest that topical antibiotics such as mupirocin, retapamulin, and fusidic acid are effective treatments for impetigo 2, 3, 5.
- Oral antibiotic therapy can be used for impetigo with large bullae or when topical therapy is impractical, with options including amoxicillin/clavulanate, dicloxacillin, cephalexin, clindamycin, doxycycline, minocycline, trimethoprim/sulfamethoxazole, and macrolides 2.
- There is no evidence to suggest that cefixime is effective or recommended for the treatment of impetigo 2, 3, 4, 5, 6.
Alternative Treatment Options
- Topical antibiotics such as mupirocin, retapamulin, and fusidic acid are effective treatments for impetigo 2, 3, 5.
- Oral antibiotic therapy can be used for impetigo with large bullae or when topical therapy is impractical 2.
- Natural therapies such as tea tree oil, olive, garlic, and coconut oils, and Manuka honey have been anecdotally successful, but lack sufficient evidence to recommend or dismiss them as treatment options 2.
- New topical antimicrobials and antiseptics are being developed as alternative treatment strategies for impetigo 6.