From the Guidelines
Impetigo should be treated with either topical mupirocin or retapamulin twice daily for 5 days for mild cases, while oral therapy is recommended for patients with numerous lesions or in outbreaks affecting several people. When considering treatment options, it's essential to weigh the severity and extent of the infection. For localized impetigo, topical antibiotics are often sufficient, but for more widespread or severe cases, oral antibiotics may be necessary 1. Some key points to consider in treatment include:
- Topical mupirocin or retapamulin are recommended for 5 days for bullous and nonbullous impetigo (strong, high) 1
- Oral therapy should be used for patients with numerous lesions or in outbreaks, with a recommended 7-day regimen of an agent active against S. aureus, such as dicloxacillin or cephalexin 1
- When MRSA is suspected or confirmed, alternative oral antibiotics like doxycycline, clindamycin, or sulfamethoxazole-trimethoprim (SMX-TMP) should be used 1 In addition to medication, gentle cleansing of the affected areas with warm water and mild soap, as well as good hygiene practices, are crucial in preventing the spread of the infection and promoting healing. It's also important to note that impetigo is typically caused by Staphylococcus aureus or Streptococcus pyogenes bacteria, and treatment should be guided by the severity of the infection and the potential for transmission to others 1.
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 treatment for impetigo is topical mupirocin ointment, 2% 2.
- It is effective against Staphylococcus aureus and Streptococcus pyogenes.
- Clinical efficacy rates for mupirocin ointment in treating impetigo were 71% to 96% in clinical studies 2.
From the Research
Treatment Options for Impetigo
The treatment for impetigo includes:
- Topical antibiotics such as mupirocin, retapamulin, and fusidic acid 3, 4, 5, 6
- Oral antibiotic therapy for impetigo with large bullae or when topical therapy is impractical 3, 7, 4
- Specific oral antibiotics that can be used include amoxicillin/clavulanate, dicloxacillin, cephalexin, clindamycin, doxycycline, minocycline, trimethoprim/sulfamethoxazole, and macrolides 3, 7
Effectiveness of Treatment Options
- Topical antibiotic treatment has been shown to be effective in treating impetigo, with mupirocin and fusidic acid being equally effective 6
- Topical mupirocin has been shown to be slightly superior to oral erythromycin 6
- Oral antibiotics such as penicillin have been found to be less effective than other antibiotics such as erythromycin and cloxacillin 7, 6
- Disinfectant solutions have not been found to be effective in treating impetigo 6