From the FDA Drug Label
INDICATIONS AND USAGE Mupirocin ointment, 2% is indicated for the topical treatment of impetigo due to: Staphylococcus aureus and Streptococcus pyogenes. The antibiotic treatment guidelines for Impetigo are to use Mupirocin ointment, 2% for the topical treatment of impetigo due to:
- Staphylococcus aureus
- Streptococcus pyogenes 1
From the Research
In Australia, the recommended first-line antibiotic treatment for impetigo is oral cephalexin (500mg four times daily for adults; 12.5-25mg/kg up to 500mg four times daily for children) for 5-7 days, as supported by the most recent evidence 2. For localized non-bullous impetigo, topical mupirocin 2% ointment applied three times daily for 7 days is appropriate, as it has been shown to be as effective as systemic erythromycin in treating pyoderma and impetigo 3. Some key points to consider when treating impetigo include:
- The importance of gentle removal of crusts with warm water and soap before applying topical antibiotics
- The need for patients to use separate towels and bedding to prevent spread
- The importance of completing the full course of antibiotics even if symptoms improve quickly
- The potential for complications such as cellulitis, bacteremia, and post-streptococcal glomerulonephritis if left untreated Alternative oral options include dicloxacillin or flucloxacillin (500mg four times daily for adults; 12.5-25mg/kg up to 500mg four times daily for children), as discussed in earlier studies 4, 5, 6. For patients with penicillin allergy, oral trimethoprim-sulfamethoxazole or clindamycin can be used, as suggested by earlier research 4, 6. It is essential to note that the rising rates of bacterial resistance to standard treatment regimens should inform treatment decisions, as highlighted in the most recent study 2.