Management

For the management of impetigo

• Use topical antibiotics for localised areas [1-3]. Clean crust before applying. Fucidin , though often used, is frequently ineffective due to resistance. Mupirocin 2% is the best choice
• To combat the resistance, antibiotic creams are often combined with antiseptics such as chlorhexidine
• Systemic antibiotics (generally flucloxacillin) are needed for extensive areas and infected dermatitis
• Inpatient care is required for infants with bullous impetigo and patients with widespread impetigenised dermatitis who may develop sepsis or dehydration
• Neonates have a much higher incidence of developing sepsis and meningitis so require paediatric referral
• Follow-up is required if lesions have not cleared in 7 days. Children should not return to day-care or school until the lesions clear
• Carers should avoid contact with lesions, towels etc. Wash clothing, toys and hands frequently