Is amoxicillin-clavulanic acid (Augmentin) effective for impetigo?

From the Guidelines

Amoxicillin-clavulanic acid is an effective treatment for impetigo, with a recommended dosage of 875 mg amoxicillin/125 mg clavulanic acid taken twice daily for 7 days in adults, and 25 mg/kg/day of the amoxicillin component in 2 divided doses in children. This antibiotic combination is effective against the bacteria that typically cause impetigo, including Staphylococcus aureus and Streptococcus pyogenes 1. The treatment guidelines recommend oral therapy for patients with numerous lesions or in outbreaks affecting several people to help decrease transmission of infection 1.

Key Considerations

• The dosage for adults is 875 mg amoxicillin/125 mg clavulanic acid taken twice daily for 7 days 1.
• The dosage for children is based on weight, usually 25 mg/kg/day of the amoxicillin component in 2 divided doses 1.
• It's essential to complete the full course of treatment even if symptoms improve before it's finished.
• Take the medication with food to reduce stomach upset.
• Amoxicillin-clavulanic acid works by inhibiting bacterial cell wall synthesis, while the clavulanic acid component prevents bacterial enzymes from breaking down the amoxicillin.

Additional Recommendations

• Gently wash the affected areas with soap and water several times daily.
• Avoid scratching to prevent further infection.
• Use separate towels and washcloths to prevent spreading the infection to others or to other parts of your body.
• Consider topical treatments like mupirocin or retapamulin ointment for patients with a limited number of lesions 1.

The most recent and highest quality study 1 supports the use of amoxicillin-clavulanic acid as an effective treatment for impetigo, and its recommendations should be prioritized in clinical practice.

From the FDA Drug Label

Amoxicillin and clavulanic acid has been shown to be active against most isolates of the following bacteria, both in vitro and in clinical infections as described in the INDICATIONS AND USAGE section Gram-positive Bacteria Staphylococcus aureus The following in vitro data are available, but their clinical significance is unknown At least 90 percent of the following bacteria exhibit an in vitro minimum inhibitory concentration (MIC) less than or equal to the susceptible breakpoint for amoxicillin and clavulanic acid. Gram-positive Bacteria Staphylococcus aureus Streptococcus pyogenes

The effectiveness of amoxicillin-clavulanic acid (Augmentin) for impetigo is supported by its activity against Staphylococcus aureus and Streptococcus pyogenes, which are common causes of impetigo. However, the label does not explicitly state its effectiveness for this specific condition.

• The drug is active against Staphylococcus aureus and Streptococcus pyogenes.
• These bacteria are commonly associated with impetigo.
• However, the label does not provide direct evidence of its effectiveness for impetigo 2.

From the Research

Effectiveness of Amoxicillin-Clavulanic Acid for Impetigo

• Amoxicillin-clavulanic acid (Augmentin) is one of the oral antibiotics that can be considered for the treatment of impetigo, especially for patients with extensive disease 3.
• However, there is no clear preference among antistaphylococcal penicillins, amoxicillin/clavulanate, cephalosporins, and macrolides for the treatment of impetigo 3.
• Topical antibiotics, such as mupirocin and fusidic acid, are effective and may be superior to oral antibiotics, including amoxicillin-clavulanic acid, for the treatment of impetigo 3, 4.
• A study found that topical mupirocin was slightly superior to oral erythromycin, but there were no significant differences in cure rates from treatment with topical versus other oral antibiotics, including amoxicillin-clavulanic acid 4.
• The choice of antibiotic should be based on the severity of the disease, the presence of resistant bacteria, and the patient's preferences and circumstances 5.
• With the increasing prevalence of antibiotic-resistant bacteria, there is a need for new topical antimicrobials and antiseptics as an alternative treatment strategy for impetigo 6.

Comparison with Other Treatments

• Topical antibiotics, such as mupirocin, ozenoxacin, and retapamulin, have shown greater resolution of impetigo compared to vehicle in clinical trials 7.
• Mupirocin has shown clinical efficacy against MRSA, but a bacterial culture is recommended to rule out resistance 7.
• Amoxicillin-clavulanic acid is not specifically mentioned as a comparison to these topical antibiotics in the studies reviewed 7.