Impetigo treatment

Clinical response should be seen within 7 days of initiating antimicrobial therapy for impetigo. Treatment faUmes could be due to noncompliance or antimicrobial resistance. A follow-up culture of exudates should be collected for cultme and sensitivity, with treatment modified accordingly. ... 

O Impetigo is a skin infection that most commonly afflicts young children. It is caused by group A streptococci or Staphylococcus aureus and is characterized by the development of numerous blisters that rupture and form crusts. Dicloxacillin, cephalexin, and topical mupirocin are considered the antibiotics of choice for treatment of impetigo. 

Potassium permanganate (KMnO ) is a purplish crystal-like oxidizing compound used as an antiseptic and disinfectant to inhibit the growth of harmful skin microorganisms and bacteria. Before antibiotics were available, it was used as a treatment for trench mouth and impetigo. 

Antibacterial treatment is generally not required in cases of gastroenteritis. Typhoid fever is treated with ciprofloxacin (quinolone), cefotaxime (third generation cephalosporin) or chloramphenicol. Impetigo necessitates the systemic use of flucloxacillin or erythromycin. Topical fusidic acid or mupirocin may also be used. 

Q83 Patients using Elidel cream should be advised to avoid alcoholic drink during treatment. Elidel may cause folliculitis and impetigo as side-effects. 

Elidel cream consists of pimecrolimus, which is a calcineurin inhibitor that is used for eczema or psoriasis. Patients should be advised to avoid alcoholic drink during the treatment period as consumption of alcohol may lead to facial flushing and skin irritation. Side-effects associated with the topical administration of pimecrolimus include a burning sensation, pruritus, erythema and skin infections, including folliculitis and, less commonly, impetigo. 

Hypersensitivity to any component monotherapy in primary bacterial infections such as impetigo, paronychia, erysipelas, cellulitis, angular cheilitis, erythrasma (clobetasol), treatment of rosacea, perioral dermatitis, or acne use on the face, groin, or axilla (very high or high potency agents) ophthalmic use. 

When considering antimicrobial therapy in a patient with fever, one should answer the following questions. First, is the fever caused by an infection If affirmative, data are needed to determine the severity of the infection, the site of infection, and the causal micro-organism(s). Second, when the cause of the fever is infectious, one should ask is treatment with antimicrobial drugs needed Many soft tissue infections including impetigo and decubital ulcers are best treated with local antiseptics and/or wound debridement without the use of antibiotics. If the chance to cure the infection with antimicrobial... 

Post-streptococcal glomerulonephritis is the result of infection with the nephritogenic strain of group A hemolytic streptococci. The streptococci are usually isolated from patients with a sore throat and, in developing countries, skin infection like impetigo or infected scabies is an important cause. There is no specific treatment except for antihypertensives, salt restriction and diuretics. Corticosteroids are of no value. The disease is self-limiting but, in some adults, it may progress to chronic renal failure. 

Parents brought their 3-year-old boy to the outpatient clinic because of a facial rash. Today the patient was one of several children sent home from day care because of similar rashes. Physical examination revealed a normal, healthy boy with discrete erythematous papular eruptions on his cheeks. There were no vesicles or bullae. The rash was covered with a honey crust, suggesting impetigo. Which of the following treatments would be most appropriate ... 

Mupirocin is indicated for topical treatment of minor skin infections, such as impetigo (see Chapter 61). Topical application over large infected areas, such as decubitus ulcers or open surgical wounds, has been identified as an important factor... 

Mupirocin (pseudomonic acid A) is structurally unrelated to other currently available topical antibacterial agents. Most gram-positive aerobic bacteria, including methicillin-resistant S aureus (MRSA), are sensitive to mupirocin (see Chapter 50). It is effective in the treatment of impetigo caused by S aureus and group A -hemolytic streptococci. 

Retapamulin is a semisynthetic pleromutilin derivative effective in the treatment of uncomplicated superficial skin infection caused by group hemolytic streptococci and S aureus, excluding MRSA. Topical retapamulin 1% ointment is indicated for use in adult and pediatric patients, 9 months or older, for the treatment of impetigo. Recommended treatment regimen is twice-daily application for 5 days. Retapamulin is well tolerated with only occasional local irritation of the treatment site. 

Clavulanic acid is manufactured by SmithKline Beecham and is sold as oral and parenteral products in combination with amoxycillin under the trade name of Augmentin, and as an injectable product in combination with ticarcillin under the trade name of Timentin. Augmentin is prescribed for infections of the respiratory tract such as bronchitis, and ear, nose and throat infections such as otitis media and sinusitis. It is also indicated for infections of the urinary tract, such as gonorrhoea, and skin and soft tissue infections, which include cellulitis, impetigo and abscesses. Timentin meanwhile is used for the treatment of severe infections in hospitalised patients with impaired or suppressed host defences. 

Superficial bacterial infections, e.g. impetigo, eczema, are commonly staphylococcal or streptococcal. They are treated by a topical antimicrobial for less than 2 weeks and applied twice daily after removal of crusts that prevent access of the drug, e.g. by a povidone-iodine preparation. Very extensive cases need systemic treatment. 

A recurrence of herpes lesions should be anticipated, and preventive treatment should be taken if necessary. Scratch lesions can trigger impetigo on the face. Scratching is the only explanation for signs of infection after a peel with Unna s paste or Jessner s solution. 

Any person with any kind of infection should be kept away from the treatment room it is out of the question to perform a phenol peel when suffering from a sore throat, tracheitis, impetigo or a fungal infection on the hands. 

Impetigo, a superficial skin infection characterized by fluid-filled vesicles that develop rapidly into pus-filled blisters that rupture to form golden-yellow crusts, is caused by S. aureus and/or S. pyogenes and occurs most commonly in children. Dicloxacillin is used commonly for treatment, although topical antibiotics such as mupirocin are also effective. 

Although impetigo may resolve spontaneously, antimicrobial treatment is indicated to relieve symptoms, prevent formation of new lesions, and prevent complications, such as cellulitis. PeniciUinase-resistant penicillins (dicloxacUlin 12.5 mg/kg orally daily in fom divided doses for children) are preferred for treatment because of the increased incidence of infections caused by S. aureus. First-generation cephalosporins are also effective, although they are generally more expensive. Cephalexin (25-50 mg/kg orally daily in two divided doses for children) and cefadroxU (30 mg/kg oraUy daily in two divided doses for children) are used commonly. Penicillin, administered as either a single intramuscular dose of benzathine penicillin G (300,000-... 

Britton JW, Fajardo JE, Krafte-Jacobs B. Comparison of mupirocin and 38. erythromycin in the treatment of impetigo. J Pediatr 1990 117 827-829. 

Loracarbef, a synthetic beta lactam antibiotic of the car-bacephem class (200 to 400 mg p.o. q. 12 hours), is used in the treatment of secondary bacterial infections of acute bronchitis, acute bacterial exacerbations or chronic bronchitis, of pneumonia, pharyngitis, tonsillitis, sinusitis, acute otitis media, uncomplicated skin and skin-structure infections, impetigo, uncomplicated cystitis, and in uncomplicated pyelonephritis. 

Mupirocin is an antibiotic agent that inhibits bacterial protein synthesis. It is indicated in treatment of impetigo caused by Staphylococcus aureus and Streptococcus pyogenes (topical ointment) and treatment of secondarily infected traumatic skin lesions (up to 10 cm in length or 100 cm in area). 

Mupirocin is available as a 2% cream and a 2% ointment for dermatologic use, and as a 2% ointment for intranasal use. The dermatologic preparations are indicated in treatment of traumatic skin lesions and impetigo secondarily infected with S. aureus or S. pyogenes. 

Mupirocin (2% ointment) is used as a topical treatment of impetigo due to S. aureus, beta-hemolytic Streptococcus, and S. pyogenes. 

Vaccinia immune globulin IV is a vaccinia-specific immunoglobulin G (IgG), which directly neutralizes vaccinia virus. It is indicated in treatment and/or modification of aberrant infections induced by vaccinia virus (including accidental implantation in eyes, mouth, or other areas where vaccinia infection would constitute a special hazard), eczema vaccinatum, progressive vaccinia, severe generalized vaccinia, and vaccinia infections in individuals who have skin conditions such as bums, impetigo, varicella-zoster, or poison ivy, or in individuals with eczematous skin lesions. Treat complications that include vaccinia keratitis with caution. 

Actions and Uses.—Externally — As an excitant, rubefacient, antiseptic, and deodorizer in the treatment of thrash in the horse, and of broken horns and punctured wounds of the belly and chest of cattle foot-rot in sheep and in mange, eczema, impetigo, and other skin affections. ... 

Generally speaking, microdennabrasion is regarded as a safe, minimally invasive treatment, with a low potential for side effects. Microdennabrasion is, however, contraindicated in cases of active infection, such as herpes simplex, impetigo and flat warts, and active pustular or cystic acne [12], Malignant tumors, keratoses. 

Zinc oxide occurs in nature as the mineral zincite, and can be prepared from zinc metal by vaporization and oxidation. It can also be prepared from franklinite or zinc sulfide. It is a very fine, odorless, amorphous, white or yellowish white powder. Zinc oxide has a mild astringent, protective and antiseptic action, and is usually formulated into ointment, paste or lotion vehicles. It is used widely in the treatment of dry skin and disorders such as acne vulgaris, prickly heat, insect bites, ivy poisioning, diaper rash, seborreha, impetigo, and psoriasis. It is also contained in some simscreens. 

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