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Topical mupirocin vs. systemic erythromycin treatment for pyoderma
1Scottsdale Pediatrics, AZ 85251.
Abstract:
Although topical antibiotics have been considered less than effective agents in the treatment of "impetigo," recent experience suggests that topical therapy has a place as primary treatment of pyoderma and impetigo. This bacteriologically controlled, randomized study compared the safety and efficacy of mupirocin with oral erythromycin in the treatment of pyoderma and impetigo. A total of 29 mupirocin-treated and 30 erythromycin-treated patients completed the study. None of the mupirocin-treated patients reported adverse experiences compared with 4 erythromycin-treated patients who reported 6 adverse experiences. The mupirocin-treated group had a significantly higher benefit:risk ratio than the erythromycin-treated group as measured by the investigator's global evaluation (P = 0.01). Both treatments eradicated 100% of the two most common pathogens, Staphylococcus aureus and Streptococcus pyogenes. Results from this study demonstrate that mupirocin is as effective as systemic erythromycin ethylsuccinate for treatment of pyoderma and impetigo.
Insights
Topical mupirocin is as effective as oral erythromycin for treating impetigo and pyoderma. Mupirocin showed a better benefit-risk ratio with fewer adverse events in this randomized study.
Area of Science:
- Dermatology
- Infectious Diseases
- Pharmacology
Background:
- Topical antibiotics were historically considered less effective for impetigo.
- Recent evidence suggests topical therapy can be a primary treatment for pyoderma and impetigo.
Purpose of the Study:
- To compare the safety and efficacy of topical mupirocin versus oral erythromycin for treating pyoderma and impetigo.
- To evaluate the benefit:risk ratio of mupirocin compared to erythromycin.
Main Methods:
- A bacteriologically controlled, randomized study.
- 29 patients received mupirocin, and 30 patients received erythromycin.
- Adverse experiences and investigator's global evaluation were recorded.
Main Results:
- No adverse experiences were reported in the mupirocin group.
- 4 erythromycin-treated patients reported 6 adverse experiences.
- Mupirocin demonstrated a significantly higher benefit:risk ratio (P = 0.01).
- Both treatments achieved 100% eradication of Staphylococcus aureus and Streptococcus pyogenes.
Conclusions:
- Topical mupirocin is a safe and effective alternative to oral erythromycin for impetigo and pyoderma.
- Mupirocin offers a favorable safety profile compared to systemic erythromycin.
- Topical mupirocin is a viable primary treatment option for bacterial skin infections.