From the Guidelines
Impetigo should not be treated with amoxicillin as the first line of treatment, but rather with dicloxacillin or cephalexin for oral therapy, or topical mupirocin or retapamulin for mild cases, as recommended by the Infectious Diseases Society of America 1. When considering treatment for impetigo, it's essential to differentiate between mild and more extensive cases. For mild cases, topical antibiotics such as mupirocin or retapamulin are effective and can be applied twice daily for 5 days 1.
Key Considerations for Treatment
- For more extensive impetigo, oral antibiotics are recommended, with dicloxacillin or cephalexin being preferred options due to their efficacy against Staphylococcus aureus, a common cause of impetigo 1.
- The dosage for dicloxacillin is 250 mg four times daily for adults, and for cephalexin, it is 250 mg four times daily for adults or 25-50 mg/kg/day divided into three or four doses for children 1.
- Amoxicillin is not the first choice for treating impetigo due to the potential for resistance, especially in areas with high prevalence of methicillin-resistant Staphylococcus aureus (MRSA) 1.
Additional Recommendations
- Good hygiene practices, including handwashing, avoiding sharing personal items, and keeping fingernails short, are crucial to prevent the transmission of impetigo to others.
- Gentle cleansing of affected areas with warm water and mild soap can help remove crusts and promote healing.
- Patients should complete the full course of antibiotics even if symptoms improve quickly to ensure complete eradication of the infection.
From the Research
Treatment for Impetigo
- Impetigo is a highly contagious, superficial skin infection that can be treated with topical or oral antibiotics, depending on the severity and extent of the infection 2, 3.
- Topical antibiotics such as mupirocin, retapamulin, and fusidic acid are effective for treating impetigo, especially for localized cases 4, 5.
- Oral antibiotics like amoxicillin/clavulanate, dicloxacillin, cephalexin, and clindamycin can be used for more extensive or severe cases of impetigo 2, 6.
Use of Amoxicillin for Impetigo
- Amoxicillin can be used to treat impetigo, but it is often used in combination with clavulanic acid to enhance its effectiveness against certain bacteria 2, 6.
- The dosage and duration of amoxicillin treatment for impetigo are not specified in the provided studies, but oral antibiotics are typically given for 10 days 6.
- It is essential to consider the increasing prevalence of antibiotic-resistant bacteria, including methicillin-resistant Staphylococcus aureus (MRSA), when selecting treatment for impetigo 2, 5.
Considerations for Treatment
- The choice of antibiotic treatment for impetigo should be based on the severity and extent of the infection, as well as the presence of antibiotic-resistant bacteria in the local area 2, 5.
- Topical disinfectants are not recommended for treating impetigo, as they are inferior to antibiotics and may not effectively eradicate the infection 2, 3.
- Natural therapies, such as tea tree oil and Manuka honey, have been anecdotally successful in treating impetigo, but there is limited evidence to support their use as a primary treatment option 2.