From the Guidelines
The first-line antibiotic treatment for infant folliculitis is typically topical mupirocin (Bactroban) 2% ointment applied to affected areas three times daily for 7-10 days. This recommendation is based on the guidelines provided by the Infectious Diseases Society of America, which suggest that for mild cases with localized disease, topical treatment with mupirocin may be adequate in full-term neonates and young infants 1.
When treating infants with folliculitis, it's essential to keep the affected areas clean by gently washing with mild soap and water before applying medication. Parents should be advised to:
- Use clean washcloths and towels each time
- Change the infant's clothing and bedding daily
- Keep the infant's nails short to prevent scratching and further spreading the infection
Improvement should be seen within 48-72 hours of starting treatment. Folliculitis in infants is typically caused by Staphylococcus aureus bacteria, which mupirocin effectively targets 1. If the condition doesn't improve with first-line treatment, the infant should be reevaluated as community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) may be the cause, requiring different antibiotic therapy.
It's worth noting that tetracyclines should not be used in children < 8 years of age 1, and for hospitalized children with complicated skin and soft tissue infections (cSSTI), vancomycin is recommended 1. However, for mild cases of folliculitis, topical mupirocin remains the preferred initial treatment.
From the Research
First-Line Antibiotic Treatment for Infant Folliculitis
- The first-line antibiotic treatment for infant folliculitis is not explicitly stated in the provided studies, but some studies suggest the use of topical antibiotics such as mupirocin ointment 2, 3, 4.
- Mupirocin ointment has been shown to be effective in treating superficial skin infections, including folliculitis, with a high level of activity against staphylococci and beta-haemolytic streptococci 2, 3, 4.
- In one study, mupirocin ointment was compared to fusidic acid ointment in the treatment of primary and secondary skin infections, and both treatments were found to be similarly effective 4.
- Another study found that oral antibiotics such as tetracyclines and the combination of clindamycin and rifampicin were effective in treating folliculitis decalvans, a rare neutrophilic scarring alopecia 5.
- However, it is essential to note that the treatment of infant folliculitis should be guided by the specific cause of the infection and the severity of the symptoms, and antibiotic treatment should only be used under the guidance of a healthcare professional 6.