How to manage Impetigo topically?
Hello, my neighbor's 3-year-old boy, is having facial rash. According to his mother, the rash started 4 days ago as little red bumps below his nose. The rash has spread around his mouth and chin. The rash also has changed in appearance to flat, reddened areas with fluid-filled pustules. Some of the pustules have ruptured, leaving weepy, red lesions and honey-colored crusts. The affected area is not excessively warm or swollen. Pediatrician suspects that the baby has impetigo. He explains to the mother that impetigo is a contagious condition that requires treatment with antibiotics. He knows that the most common pathogen causing impetigo is Staphylococcus aureus. My neighbor comments that the baby will not take any medications by mouth. Are there any topical options available to treat impetigo?
@rajanya Because many cases of impetigo involve coinfection with streptococci, antibiotic selection must consider covering for both organisms. Antimicrobial agents that will cover for both organisms include dicloxcillin, cephalexin, erythromycin, and amoxicillin/clavulanate. Since the baby will not take oral antibiotics, mupirocin ointment is another option. Mupirocin should be used only for mild cases, however. The pediatrician should advise the mother about the importance of not spreading the infection to the rest of the family (or even to other parts of his body). The most important measure of prevention is frequent hand washing. The baby also should be reminded not to touch the rash.