Prescribing antibiotics for impetigo

Impetigo, a contagious superficial pyogenic infection of the skin, can be treated orally or topically. Nowadays oral erythromycin is the treatment of choice, although flucloxacillin is preferred in areas where the causative micro-organisms are resistant to erythromycin. Topical mupirocin ointment has shown itself to be as effective as oral therapy in many cases and is less likely to be associated with unwanted effects. The availability of 2 forms of therapy-oral and topical-means that treatment can be tailored according to the preferences of the patient. Consequently, drug therapy is more likely to be used appropriately. Arguments for and against the prescribing of each form of therapy are presented.