Do Antimicrobial Resistance Patterns Matter? An Algorithm for the Treatment of Patients With Impetigo

Area of Science:

• Dermatology
• Infectious Diseases
• Pharmacology

Background:

• Impetigo is a contagious bacterial skin infection affecting children and adults.
• Caused primarily by Staphylococcus aureus and Streptococcus pyogenes.
• Antimicrobial resistance necessitates updated treatment strategies.

Purpose of the Study:

• To develop an evidence-based treatment algorithm for impetigo in pediatric and adult populations.
• To incorporate antimicrobial stewardship principles into impetigo management.
• To address the growing concern of antibiotic resistance.

Main Methods:

• An international expert panel utilized a modified Delphi technique.
• Treatment recommendations were evidence-based.
• Consideration was given to antimicrobial stewardship and antibiotic resistance trends.

Main Results:

• The algorithm covers impetigo education, prevention, diagnosis, classification, treatment, and follow-up.
• Localized impetigo is defined as fewer than ten lesions in patients over two months old without immune compromise.
• Widespread resistance to common topical and oral antibiotics like mupirocin has been reported.

Conclusions:

• Local antibiotic resistance patterns are crucial for prescribing.
• Ozenoxacin cream 1% demonstrates high efficacy against S. pyogenes and S. aureus, including MRSA.
• Ozenoxacin may be a viable treatment for localized impetigo.