Diagnosis and treatment of impetigo

Sixty patients with impetigo were seen in a private practice. Cultures of specimens from all but one patient grew coagulase-positive Staphylococcus aureus. The culture of one patient grew pure group A beta-hemolytic streptococcus. The cultures of six patients were mixed, having streptococci and S. aureus. In all but one instance the staphylococci were resistant to penicillin and ampicillin. We recommend that all centers treating patients with superficial skin infections have a method of screening or spot checking their patient population to determine antibiotic sensitivities and the frequency and distribution of these infections. Then, if bacteriologic and antibiotic sensitivity studies mandate, a switch in antibiotics should be contemplated.