Impetigo Organism-Specific Therapy 

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Impetigo Organism-Specific Therapy 

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Organism-specific therapeutic regimens for impetigo are provided below, including those for group A beta-hemolytic Streptococcus, methicillin-susceptible Staphylococcus aureus (MSSA), and methicillin-resistant S aureus (MRSA).

Impetigo is a contagious, superficial bacterial infection commonly seen in children. Treatment typically involves local wound care along with topical or systemic antibiotic therapy with activity against beta-hemolytic streptococci and S aureus.

Topical therapy is preferred for localized, uncomplicated nonbullous or bullous impetigo. [1] Systemic antibiotics are used with widespread infections, complicated infections, outbreaks of poststreptococcal glomerulonephritis, multiple incidents that have occurred within the home, daycare, or athletic-team settings. The duration of therapy should be based on clinical improvement; however, a 7-day regimen is recommended. [2]

The Infectious Diseases Society of America (IDSA) published 2014 guidelines for the treatment of impetigo (see Practice Guidelines for the Diagnosis and Management of Skin and Soft Tissue Infections: 2014 Update by the Infectious Diseases Society of America). [2]

Group A beta-hemolytic streptococcal impetigo

Localized, uncomplicated group A beta-hemolytic streptococcal impetigo is treated as follows:

Widespread, complicated group A beta-hemolytic streptococcal impetigo is treated as follows:

MSSA impetigo

Localized, uncomplicated MSSA impetigo is treated as follows:

Widespread, complicated MSSA impetigo is treated as follows:

MRSA impetigo  [3, 4]

Localized, uncomplicated MRSA impetigo is treated as follows:

Widespread, complicated MRSA impetigo is treated as follows:

Koning S, van der Sande R, Verhagen AP, van Suijlekom-Smit LW, Morris AD, Butler CC, et al. Interventions for impetigo. Cochrane Database Syst Rev. 2012 Jan 18. 1:CD003261. [Medline].

Stevens DL, Bisno AL, Chambers HF, Dellinger EP, Goldstein EJ, Gorbach SL, et al. Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the infectious diseases society of america. Clin Infect Dis. 2014 Jul 15. 59(2):e10-52. [Medline].

[Guideline] Liu C, Bayer A, Cosgrove SE, Daum RS, Fridkin SK, Gorwitz RJ, et al. Clinical practice guidelines by the infectious diseases society of america for the treatment of methicillin-resistant Staphylococcus aureus infections in adults and children. Clin Infect Dis. 2011 Feb 1. 52 (3):e18-55. [Medline].

Geria AN, Schwartz RA. Impetigo update: new challenges in the era of methicillin resistance. Cutis. 2010 Feb. 85(2):65-70. [Medline].

Lisa S Lewis, MD Attending Physician, Division of Emergency Medicine, Cincinnati Children’s Hospital Medical Center

Lisa S Lewis, MD is a member of the following medical societies: American Academy of Pediatrics

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Thomas E Herchline, MD Professor of Medicine, Wright State University, Boonshoft School of Medicine; Medical Consultant, Public Health, Dayton and Montgomery County (Ohio) Tuberculosis Clinic

Thomas E Herchline, MD is a member of the following medical societies: Alpha Omega Alpha, Infectious Diseases Society of America, Infectious Diseases Society of Ohio

Disclosure: Nothing to disclose.

Impetigo Organism-Specific Therapy 

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