What is the Treatment for Localised Non-Bullous Impetigo When the Patient is Not Systemically Unwell?
This page outlines the evidence-based approach for localised non-bullous impetigo in adults and children who are not systemically unwell and not at high risk of complications.
Clinical Scenario
Localised non-bullous impetigo; not systemically unwell; not at high risk of complications. For this population, topical therapy (such as hydrogen peroxide 1% cream) may be considered as part of the overall antimicrobial approach alongside oral options.
Treatment Approach
The recommended approach involves a short course of oral antibiotic therapy. The selection of the appropriate antibiotic takes into account individual patient circumstances, including allergy status and other relevant factors.
Full antibiotic selection, dosing schedules, and duration guidance are in the complete structured protocol — see below.
Treatment Goal
Cure or improvement of non-bullous impetigo by the end of the treatment course. A 5-day course is usually appropriate, though duration may be adjusted based on clinical judgement.
References
- Consider hydrogen peroxide 1% cream for people with localised non-bullous impetigo who are not systemically unwell or at high risk of complications (see recommendations on choice of antimicrobial).
- For people with impetigo that is worsening or has not improved after completing a course of topical antibiotics: offer a short course of an oral antibiotic (see the recommendations on choice of antimicrobial).
- A 5-day course is usually appropriate but can be increased to 7 days based on clinical judgement, depending on the severity and number of lesions.
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