Impetigo, considerations and treatment

What is impetigo?
Impetigo is a bacterial skin infection that can affect patients of all ages. However, it's very common among kids, especially preschoolers and school-age kids. It can cause blisters or sores on the face, hands, legs, and diaper area (Murren-Boezem, J, 2018).

What is the recommended treatment?
Impetigo is usually treated topically unless it is a moderate to severe case. First-line therapy for impetigo is mupirocin (Bactroban). Treatment of impetigo should be with either mupirocin or retapamulin twice daily (bid) for 5 days (Stevens et al, 2014).

Practice Guidelines for the Diagnosis and Management of Skin and Soft Tissue Infections: 2014 Update by the Infectious Diseases Society of America (Stevens et al, 2014).

Antibiotic	Dosage, Adults	Dosage, Children	Comment
Mupirocin ointment	Apply to lesions bid	Apply to lesions bid	For patients with limited number of lesions

Is education required? 

Patients started on mupirocin should be educated on the importance of completing the medication regimen as instructed, to avoid the development of bacterial resistance (Stevens et al, 2014). 

Is follow up required? 

Patients will need follow-up visits, to assess whether impetigo has resolved, or if a different treatment is required. 

Labs 

No routine tests recommended

References

Murren-Boezem, J. (2018). Impetigo. Retrieved from http://kidshealth.org/en/parents/impetigo.html

Dennis L. Stevens, Alan L. Bisno, Henry F. Chambers, E. Patchen Dellinger,

Ellie J. C. Goldstein, Sherwood L. Gorbach, Jan V. Hirschmann, Sheldon

L. Kaplan, Jose G. Montoya, James C. Wade; Practice Guidelines for the Diagnosis and Management of Skin and Soft Tissue Infections: 2014 Update by the Infectious Diseases Society of America, Clinical Infectious Diseases, Volume 59, Issue 2, 15 July 2014, Pages e10–e52, https://doi.org/10.1093/cid/ciu296