References Impetigo is a highly contagious, superficial skin infection that most commonly affects children two to five years of age. The two types of impetigo are nonbullous impetigo i. The diagnosis usually is made clinically, but rarely a culture may be useful. Although impetigo usually heals spontaneously within two weeks without scarring, treatment helps relieve the discomfort, improve cosmetic appearance, and prevent the spread of an organism that may cause other illnesses e.
Editor—Koning et al report the results of a clinical trial that showed the efficacy of topical fusidic acid as treatment of patients with impetigo. Koning et al observed that none of the pretreatment isolates of Staphylococcus aureus was resistant to fusidic acid and concluded that many years of use of topical fusidic acid has not resulted in appreciable resistance in staphylococci in the general population.
These findings illustrate one of the problems surrounding antimicrobial resistance—namely, that patterns of resistance in one country cannot be extrapolated to those in another.
Specifically, data for resistance rates to fusidic acid among S aureus isolates in the United Kingdom differ markedly from those in the Netherlands. In a survey of 28 centres in the United Kingdom the incidence of resistance to fusidic acid among S aureus isolates from the community excluding strains of methicillin resistant S aureus, which, by their clonal nature, might distort the data increased from 8.
We cannot explain why the Dutch experience does not mirror our own, although Koning et al have not specified the technique they used to determine the susceptibilities of their isolates, nor have they provided information about the susceptibilities to fusidic acid of any isolates after treatment.
A further confounding factor could be the small number of isolates tested 67 strains ; evaluating a larger, and therefore more representative, sample might yield a different pattern of resistance.
We do not dispute the efficacy of topical fusidic acid as treatment of patients with impetigo and other superficial skin infections. But fusidic acid is a very valuable drug that is also administered systemically in combination with another antistaphylococcal antibiotic, usually flucloxacillin, as treatment of patients with severe staphylococcal infections.
Rates of resistance to this agent among S aureus isolates are increasing in the United Kingdom, directly in line with usage, and we are concerned that further increases in the prescribing of topical fusidic acid will result in even higher levels of resistance.
The price of continuing to administer the drug in this way will, in the long term, be the loss of the therapeutic efficacies of both the topical and systemic formulations, and we urge restraint, particularly among general practitioners and dermatologists.Recent reports indicate that multiple bacterial organisms have successfully developed resistance to these 2 drugs.
14,15 This rising prevalence increasingly limits their use to specific conditions, e.g., systemic fusidic acid for severe bone infections and topical mupiricin to eradicate nasal methicillin-resistant Staphylococcus aureus (MRSA.
|Fusidic acid cream for impetigo - Europe PMC Article - Europe PMC||In addition to providing direct patient care, she acts as a sub-investigator in multiple clinical studies involving psoriasis, onychomycosis, and acne. Abstract Impetigo is a gram-positive bacterial infection of the superficial layers of the epidermis.|
|Fusidic acid cream for impetigo||Fam Pract Oct|
|Login to Site||In the time period from June to May bacterial cultures were taken in 33 patients with impetigo and in 55 patients with secondarily infected AD. We performed a prospective study in to in one of the clinics of the Department of Dermatology, Sahlgrenska University Hospital, Gothenburg, Sweden.|
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In randomized, double- or observer-blind trials, topical retapamulin 1% ointment for 5 days was significantly more effective than placebo, and was noninferior to topical fusidic acid for 7 days in pediatric or adult patients with impetigo.
Impetigo is a highly contagious bacterial skin infection, caused by Staphylococcus aureus and Streptococcus caninariojana.com produces patches of red inflamed skin, sores and blisters and occasionally ulcerous lesions around the face, hands, armpits, back of the knees, neck and genitals, which can erupt and develop yellow-brown crusts.
Fusidic acid is a type of medicine called an antibiotic. Fusidic acid works by preventing bacteria from producing proteins that are essential to them.
Without these proteins the bacteria cannot. The evidence identified in this report supports the clinical efficacy of topical antibiotics, specifically mupirocin and fusidic acid, for the treatment of impetigo.
Insufficient evidence was identified to support the clinical efficacy of bacitracin and a lack of evidence was identified on other topical antibiotics . Authors’ conclusions There is good evidence that topical mupirocin and topical fusidic acid are equally, or more, effective than oral treatment. Due to the lack of studies in people with extensive impetigo, it is unclear if oral antibiotics.