What Is the First-Line Treatment for Bullous Impetigo?
Clinical Overview
Bullous impetigo is a superficial bacterial skin infection presenting with intact or ruptured fluid-filled blisters. First-line management is centred on topical antibiotic therapy applied directly to the affected skin, which is preferred over systemic treatment for localised disease.
Treatment Approach
Management involves topical antibiotic therapy applied to the affected skin. Evidence supports several specific antibiotic preparations for this indication — the selection among them, together with the complete application protocol, is detailed in the structured regimen.
Clinical Goal
Clinical response with resolution of the impetigo skin lesions. The protocol specifies a defined point at which to reevaluate if no clinical response is observed.
References
- Topical antibiotics are more effective than placebo and preferable to oral antibiotics for limited impetigo.
- Three topical antibiotic preparations recommended for impetigo are mupirocin 2% cream or ointment (Bactroban), retapamulin 1% ointment (Altabax), and fusidic acid (not available in United States).
- Apply to affected skin three times daily for seven to 10 days; reevaluate after three to five days if no clinical response.
- It usually resolves within two to three weeks without scarring.
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