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Rationale:
- Impetigo may be caused by streptococci and/or S. aureus.
- Mild cases of impetigo may not require systemic antibiotics.
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Evidence:
- Topical mupirocin is as effective as oral cephalexin for the treatment of impetigo caused by S. aureus, group A streptococcus, or both (117).
- Cephalexin in one report was found to be superior to dicloxacillin in the treatment of impetigo caused by S. aureus, group A streptococcus, or both (71).
- Treatment failures of impetigo caused by S. aureus, group A streptococcus, or both occurred in 24% of patients treated with penicillin, in 4% of patients treated with erythromycin,
and in 0% of patients treated with cephalexin (118).
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Comments:
- In cases of impetigo caused by group A streptococcus, treatment may not prevent post-streptococcal glomerulonephritis, but
it does aid in the clearing of lesions and is an important control measure in particular settings, such as schools and day
care centers.
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Dennis L. Stevens, PhD, MD has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations.
Lawrence J. Eron, MD, FACP has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations.
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The information included herein should never be used as a substitute
for clinical judgment and does not represent an official position of
ACP. Because all PIER modules are updated regularly, printed web pages
or PDFs may rapidly become obsolete. Therefore, PIER users should
compare the date of the last update on the website with any printout
to ensure that the information being referred to is the most current
available.
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PIER is copyrighted (c) 2008 by the American College of Physicians,
190 N. Independence Mall West, Philadelphia, PA 19106-1572, USA.
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Cellulitis and Soft Tissue Infections
> Drug Therapy
