dermatologic disorders
Impetigo and Ecthyma
Treatment of Impetigo and Ecthyma
Topicalmupirocin,retapamulin,fusidic acid, orozenoxacin Sometimes oral antibiotics The affected area should be washed gently with soap and water several times a day to remove any crusts. Treatment for localized impetigo is topicalmupirocinantibiotic ointment 3 times a day for 7 days,retapamulinointment 2 times a day for 5 days, orozenoxacin1% cream applied every 12 hours for 5 days. Fusidic acid 2% cream is not available in the United States. Oral antibiotics (eg,dicloxacillinorcephalexin250 to 500 mg 4 times a day [12.5 mg/kg 4 times a day for children] for 10 days) may be needed in patients who are immunocompromised, who have extensive or resistant impetigo lesions, or who have ecthyma. In penicillin-allergic patients,clindamycin300 mg every 6 hours orerythromycin250 mg every 6 hours may be used, but resistance to both antibiotics is an increasing problem. Use of initial empiric MRSA and purulent or complicated cellulitis is not typically advised unless there is compelling clinical evidence (eg, contact with a person who has a documented case, exposure to a documented outbreak, culture-documented local prevalence of > 10% or 15%). Treatment of MRSA should be directed by culture and sensitivity test results; typically, Other therapy includes restoring a normal cutaneous barrier in patients with underlying Atopic Dermatitis (Eczema) or extensive Prompt recovery usually follows timely treatment. Delay can cause cellulitis, lymphangitis, furunculosis, and hyperpigmentation or hypopigmentation with or without scarring. Children aged 2 to 4 years are at risk of acute glomerulonephritis if nephritogenic strains of group A streptococci are involved (types 49, 55, 57, and 59); nephritis seems to be more common in the southern United States than in other regions. It is unlikely that treatment with antibiotics prevents poststreptococcal glomerulonephritis. 