Related Experiment Videos
Impetigo contagiosa III. Comparative efficacy of oral erythromycin and topical mupirocin
L L Barton1, A D Friedman, A M Sharkey
1St. Louis University School of Medicine, Department of Pediatrics/Adolescent Medicine, Missouri.
Abstract:
Ninety-seven patients with impetigo were prospectively enrolled in a study to determine the comparative efficacy of systemic and topical antibiotic therapy. After obtaining a bacterial culture from a representative lesion, the children were randomized to receive seven days of either oral erythromycin or topical mupirocin administered three times daily. Staphylococcus aureus alone was isolated from 51% and in association with group A beta-hemolytic streptococci (GABS) from 29%; GABS alone was isolated from 4% of patients. Of 48 children who received erythromycin, 43 (90%) were clinically improved or cured, and 11 of 17 were bacteriologically cured. Of 49 children who received mupirocin, 47 (96%) were clinically improved or cured, and 10 of 14 were bacteriologically cured. At three-week follow-up, clinical cure rates and number of secondary household cases of impetigo were equivalent in both treatment groups. Mupirocin appears to be a well-tolerated, albeit expensive, alternative to erythromycin for the treatment of impetigo.
Insights
This study compared oral erythromycin and topical mupirocin for impetigo treatment in children. Both antibiotics showed high clinical cure rates, with mupirocin being a well-tolerated alternative.
Area of Science:
- Dermatology
- Infectious Diseases
- Pharmacology
Background:
- Impetigo is a common bacterial skin infection in children.
- Choosing between systemic and topical antibiotics is crucial for effective treatment.
Purpose of the Study:
- To compare the efficacy of oral erythromycin versus topical mupirocin for treating impetigo.
- To evaluate clinical and bacteriological cure rates and secondary household infections.
Main Methods:
- Prospective study of 97 children with impetigo.
- Randomization to seven-day treatment with oral erythromycin or topical mupirocin.
- Bacterial cultures obtained to identify causative pathogens, primarily Staphylococcus aureus and group A beta-hemolytic streptococci (GABS).
Main Results:
- Oral erythromycin achieved 90% clinical improvement/cure; topical mupirocin achieved 96% clinical improvement/cure.
- Bacteriological cure rates were 65% for erythromycin and 71% for mupirocin.
- Clinical cure rates and secondary household cases were equivalent between groups at three-week follow-up.
Conclusions:
- Both oral erythromycin and topical mupirocin are effective treatments for impetigo.
- Topical mupirocin is a well-tolerated alternative to erythromycin, despite its higher cost.