Impetigo: diagnosis and treatment

Area of Science:

• Pediatrics
• Dermatology
• Infectious Diseases

Background:

• Impetigo is the most common bacterial skin infection in children aged 2-5.
• It presents as nonbullous (70%) or bullous (30%) forms, caused by Staphylococcus aureus or Streptococcus pyogenes.
• Complications are rare, but antibiotic resistance is an increasing concern.

Purpose of the Study:

• To review the epidemiology, clinical presentation, and treatment of impetigo.
• To discuss the challenges posed by antibiotic-resistant bacteria in empiric treatment decisions.
• To highlight current and developing treatment options.

Main Methods:

• Literature review of impetigo epidemiology, etiology, and treatment.
• Analysis of antibiotic resistance patterns impacting therapeutic choices.
• Evaluation of topical and oral antibiotic efficacy and limitations.

Main Results:

• Nonbullous impetigo features honey-colored crusts; bullous impetigo presents with flaccid bullae.
• Standard treatments include topical antibiotics (mupirocin, retapamulin, fusidic acid) and oral antibiotics for severe cases.
• Antibiotic resistance (MRSA, macrolide-resistant Strep) necessitates careful empiric selection; clindamycin and trimethoprim/sulfamethoxazole are options with specific coverage limitations.

Conclusions:

• Impetigo management requires consideration of local antibiotic resistance patterns.
• Topical antibiotics are preferred, with oral options for extensive disease.
• Further research into novel treatments like minocycline foam and Ozenoxacin is ongoing.