Related Experiment Videos
Randomized clinical trial of topical mupirocin versus oral erythromycin for impetigo
J Goldfarb1, D Crenshaw, J O'Horo
1Division of Pediatric Pharmacology and Critical Care, Rainbow Babies and Childrens Hospital, Cleveland, Ohio.
Abstract:
The safety and efficacy of a new topical antiinfective agent, mupirocin, was compared with that of oral erythromycin ethylsuccinate in the treatment of impetigo in children. Sixty-two children aged 5 months to 13 years with impetigo were assigned to be treated with either mupirocin in three daily applications or erythromycin ethylsuccinate (40 mg/kg of body weight per day divided into four doses) according to a randomized treatment schedule. On the initial visit, exudate or cleansed infected sites or both were cultured and therapy was begun. All patients were treated for 8 days. Patients were seen again on days 4 to 5 of therapy, at the end of therapy, and 7 days after the end of therapy. Sites of infection were comparable between the groups, as were bacteriologic responses. At the first visit, 24 of 30 children in the mupirocin group and 14 of 32 children in the erythromycin group were cured or had at least a 75% reduction in size of the lesions. At the end of the study, all 29 of the children in the mupirocin group who came to follow-up, compared with 27 of 29 in the erythromycin group, were cured. Side effects were few. Five children in the erythromycin group developed mild diarrhea. Thus, mupirocin appears to be safe and effective in treating impetigo in children. Our data show a trend toward more rapid clinical response with mupirocin than with erythromycin.
Insights
Mupirocin, a topical anti-infective, demonstrated safety and efficacy in treating childhood impetigo, showing a trend toward faster healing compared to oral erythromycin ethylsuccinate.
Area of Science:
- Dermatology
- Pediatrics
- Infectious Diseases
Background:
- Impetigo is a common bacterial skin infection in children.
- Topical and oral antibiotics are standard treatments.
- Evaluating new agents like mupirocin is crucial for effective management.
Purpose of the Study:
- To compare the safety and efficacy of topical mupirocin versus oral erythromycin ethylsuccinate for treating impetigo in children.
- To assess the speed of clinical response and cure rates for both treatment groups.
Main Methods:
- A randomized trial involving 62 children aged 5 months to 13 years with impetigo.
- Treatment groups received either topical mupirocin (three daily applications) or oral erythromycin ethylsuccinate (40 mg/kg/day in four doses) for 8 days.
- Clinical and bacteriologic assessments were performed at multiple time points.
Main Results:
- Early in treatment, 24/30 children on mupirocin showed cure or >=75% lesion reduction versus 14/32 on erythromycin.
- By study end, all 29 follow-up patients on mupirocin were cured, compared to 27/29 on erythromycin.
- Mupirocin showed a trend towards a more rapid clinical response with minimal side effects.
Conclusions:
- Topical mupirocin is a safe and effective treatment option for impetigo in children.
- Mupirocin may offer a faster clinical resolution compared to oral erythromycin ethylsuccinate.
- Further research could explore mupirocin's role in pediatric infectious dermatology.