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Topical mupirocin treatment of impetigo is equal to oral erythromycin therapy
P M Mertz1, D A Marshall, W H Eaglstein
1Department of Dermatology and Cutaneous Surgery, University of Miami, School of Medicine, FL 33101.
Abstract:
Topical antimicrobial therapy has not been effective in the past against cutaneous bacterial infections. In this study, a new topical antibiotic ointment, mupirocin, was compared with oral erythromycin ethylsuccinate in the treatment of impetigo. Seventy-five patients clinically diagnosed as having impetigo and with positive cultures of Staphylococcus aureus, Streptococcus pyogenes, or both were examined in an investigator-blinded study. Patients used topical mupirocin applied three times daily or the usual oral dose of erythromycin ethylsuccinate (30 to 50 mg/kg per day). Patients' lesions were examined clinically and cultured bacteriologically on days 0, 3, and 8, and 1 week after treatment. Susceptibility testing was performed on pathogens isolated to determine antibiotic resistance. Mupirocin treatment produced similar clinical results to oral erythromycin and was superior in the eradication of S aureus, including antibiotic-resistant S aureus. These results show topical mupirocin to be a safe and effective alternative to oral antibiotic therapy in the treatment of impetigo.
Insights
New topical mupirocin ointment offers an effective treatment for impetigo, comparable to oral erythromycin. Mupirocin demonstrated superiority in eradicating Staphylococcus aureus, including resistant strains, providing a safe alternative for bacterial skin infections.
Area of Science:
- Dermatology
- Infectious Diseases
- Microbiology
Background:
- Topical antimicrobial therapies have historically shown limited efficacy against cutaneous bacterial infections.
- Impetigo is a common bacterial skin infection requiring effective treatment options.
Purpose of the Study:
- To compare the efficacy of a new topical antibiotic, mupirocin, with oral erythromycin ethylsuccinate for treating impetigo.
- To evaluate the eradication rates of Staphylococcus aureus and Streptococcus pyogenes with both treatment regimens.
Main Methods:
- An investigator-blinded study involving 75 patients diagnosed with impetigo and positive cultures for S. aureus or S. pyogenes.
- Patients received either topical mupirocin three times daily or oral erythromycin ethylsuccinate (30-50 mg/kg/day).
- Clinical and bacteriological assessments were conducted on days 0, 3, 8, and 1 week post-treatment, with antibiotic susceptibility testing performed.
Main Results:
- Topical mupirocin achieved clinical results comparable to oral erythromycin ethylsuccinate.
- Mupirocin demonstrated superior eradication of S. aureus, including antibiotic-resistant strains.
- Both treatments were well-tolerated, indicating a favorable safety profile.
Conclusions:
- Topical mupirocin is a safe and effective alternative to oral antibiotic therapy for impetigo.
- Mupirocin's efficacy against resistant S. aureus makes it a valuable option for managing this common skin infection.