Mupirocin Dosing for Impetigo in a 7-Year-Old
Apply mupirocin 2% ointment to the affected areas three times daily for 5 days. 1, 2
Dosing Specifics
- Application frequency: Three times daily (every 8 hours) 2
- Duration: 5 days for impetigo 1
- Amount: A small amount applied to each affected lesion 2
- Coverage: The treated area may be covered with a gauze dressing if desired 2
When to Use Topical vs. Oral Therapy
Mupirocin is appropriate for this 7-year-old if:
- The child has a limited number of lesions 1
- This is not part of an outbreak affecting multiple people 1
- The infection is localized and not widespread 1
Switch to oral antibiotics if:
- Numerous lesions are present 1
- There is an outbreak involving several people (to decrease transmission) 1
- No clinical response occurs within 3-5 days of topical therapy 2
Oral Antibiotic Alternatives (If Needed)
If oral therapy becomes necessary, the recommended 7-day regimens include: 1
- Cephalexin: 25-50 mg/kg/day divided into 4 doses 1
- Dicloxacillin: 25-50 mg/kg/day divided into 4 doses 1
- Clindamycin: 10-20 mg/kg/day divided into 3 doses (if MRSA suspected or clindamycin resistance <10%) 1
Important caveat: Avoid tetracyclines (doxycycline, minocycline) in this 7-year-old child, as they should not be used in children under 8 years of age 1
Clinical Pearls
- Re-evaluation timing: If the child shows no clinical response within 3-5 days, re-evaluate and consider switching to oral therapy 2
- Culture considerations: While Gram stain and culture can help identify whether Staphylococcus aureus or β-hemolytic Streptococcus is the cause, treatment without these studies is reasonable in typical cases 1
- MRSA consideration: If MRSA is suspected or confirmed based on local epidemiology or previous cultures, oral options include clindamycin, TMP-SMX, or continue mupirocin topically for limited disease 1