Impetigo (Impetigo Contagiosa)

A common superficial bacterial infection caused by STAPHYLOCOCCUS AUREUS or group A beta-hemolytic streptococci. Characteristics include pustular lesions that rupture and discharge a thin, amber-colored fluid that dries and forms a crust. This condition is commonly located on the face, especially about the mouth and nose.

Also Known As:

Networked: 538 relevant articles (58 outcomes, 75 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Infections
2.	Pyoderma
3.	Abscess
4.	Cellulitis
5.	Scabies (Sarcoptic Mange)

Experts

1.	Steer, Andrew C: 9 articles (09/2022 - 12/2015)
2.	Amagai, Masayuki: 9 articles (03/2012 - 05/2002)
3.	Romani, Lucia: 8 articles (09/2022 - 12/2015)
4.	Hebert, Adelaide A: 8 articles (06/2021 - 05/2012)
5.	Engelman, Daniel: 7 articles (09/2022 - 01/2019)
6.	Sugiura, Kazumitsu: 7 articles (03/2022 - 10/2017)
7.	Zsolt, Ilonka: 7 articles (03/2020 - 01/2018)
8.	Nishifuji, Koji: 6 articles (01/2019 - 05/2002)
9.	Kaldor, John M: 5 articles (09/2022 - 12/2015)
10.	Torrelo, Antonio: 5 articles (04/2021 - 10/2018)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Impetigo:

1.	Mupirocin (Bactroban)FDA LinkGeneric 05/01/1990 - "Randomized, multicenter, double-blind, vehicle-controlled clinical trials have shown that mupirocin is safe and effective for the treatment of impetigo." 12/01/1988 - "Thus, mupirocin appears to be safe and effective in treating impetigo in children. " 12/01/1986 - "Initial studies comparing mupirocin to inactive vehicle in the treatment of impetigo indicate an overall 92 percent pathogen eradication rate with active drug and 58 percent eradication rate with vehicle. " 12/01/2016 - "Mupirocin is used worldwide for topical treatment of infected skin lesions, impetigo, and especially for nasal decolonization of patients with carriage of Staphylococci, including methicillin-resistant Staphylococcus aureus. " 10/23/2004 - "Treatment of impetigo: save mupirocin."
2.	Ointments (Pastes)IBA 12/01/2007 - "A 1% ointment formulation has been developed for clinical use, and a placebo-controlled trial of impetigo in 210 patients produced significantly higher rates of clinical and microbiological success compared with placebo - 85.6 versus 52.1% and 91.2 versus 50.9%, respectively. " 05/01/1948 - "Sulphathiazole ointment in the treatment of impetigo contagiosa." 01/03/1942 - "Sulphathiazole Ointment in the Treatment of Impetigo." 10/01/2016 - "Currently available treatment options for impetigo are limited by either systemic side effects (for oral therapy) or lack of ease of use (for topical ointment). " 08/16/2013 - "Fusidic acid ointment was recommended as first-line treatment for localised impetigo. "
3.	ozenoxacinIBA 07/01/2019 - "Ozenoxacin 1% cream has potent bactericidal activity and was shown to be effective and safe for the treatment of impetigo in two well-controlled Phase 3 trials. " 10/01/2023 - "Topical ozenoxacin has strong efficacy in treating impetigo in pediatric patients. " 03/01/2020 - "The results of this analysis suggest that ozenoxacin 1% cream is an effective and safe treatment for impetigo in pediatric patients aged 2 months to <18 years." 01/01/2020 - "Ozenoxacin, a New Effective and Safe Topical Treatment for Impetigo in Children and Adolescents." 07/01/2019 - "The current review explored the challenges in treating impetigo in pediatric and adult populations and examined the role of ozenoxacin 1% cream as a safe and effective treatment option. "
4.	Anti-Bacterial Agents (Antibiotics)IBA 02/01/2018 - "Antibiotics are the first-line treatment when multiple lesions exist, but with an increasing prevalence of antibiotic-resistant bacteria the successful management of impetigo in the future is an area of concern. " 06/01/2021 - "Topical antibiotics had greater resolution of impetigo in comparison to vehicle in these pivotal clinical trials. " 06/01/2021 - "Randomized clinical trials that evaluated the use of topical antibiotics for treatment of impetigo were included. " 04/01/2021 - "While published antimicrobial stewardship guidelines have focused on systemic antibiotics, few studies have attempted to evaluate topical antibiotic prescribing practices for impetigo treatment. " 01/01/2021 - "Eligible studies involved participants with impetigo in either the placebo group of randomised trials, or in single-group prognostic studies that did not use antibiotics and measured time to resolution or improvement. "
5.	Fusidic Acid (Fucithalmic)IBA 02/28/2002 - "Fusidic acid cream proved effective against impetigo." 10/01/2008 - "Last year, we concluded that topical fusidic acid should be first-line treatment for impetigo. " 01/26/2002 - "Fusidic acid cream in the treatment of impetigo in general practice: double blind randomised placebo controlled trial." 01/01/2023 - "In August 2018, a public health alert was issued in Belgium regarding clusters of impetigo cases caused by the epidemic European fusidic acid-resistant impetigo clone (EEFIC) of Staphylococcus aureus. " 01/01/2023 - "Persistence of the Staphylococcus aureus epidemic European fusidic acid-resistant impetigo clone (EEFIC) in Belgium."
6.	retapamulinFDA Link 05/01/2008 - "This study shows that topical retapamulin is effective and safe in the treatment of primary impetigo, offering a new treatment option." 06/01/2021 - "Retapamulin is indicated for lesions of impetigo that are colonized by MSSA and streptococcus S. " 10/01/2008 - "Here we consider the place of retapamulin in impetigo and its other licensed indications." 10/01/2007 - "Altabax approved to treat impetigo." 01/01/2007 - "Retapamulin is a highly effective and convenient new treatment option for impetigo, with efficacy against isolates resistant to existing therapies."
7.	Erythromycin (Erycette)FDA LinkGeneric 02/01/1992 - "aureus strains in impetigo and (ii) whether an increased rate of failure of erythromycin treatment was associated with such resistance. " 05/01/1988 - "Thus, we conclude that erythromycin is the drug of choice for impetigo in our midwestern locale because of its high efficacy and relatively low cost." 09/01/1989 - "Resistance rates to erythromycin in patients with furunculosis and impetigo were 51.5% and 26.2%, respectively (p less than 0.001). " 11/01/1995 - "Evaluation of the efficacy of josamycin in the treatment of impetigo in children and its in vitro activity on erythromycin resistant Staphylococcus aureus strains." 06/01/1989 - "Impetigo contagiosa III. Comparative efficacy of oral erythromycin and topical mupirocin."
8.	Erythromycin Ethylsuccinate (E-Mycin E)FDA LinkGeneric 12/01/1988 - "The safety and efficacy of a new topical antiinfective agent, mupirocin, was compared with that of oral erythromycin ethylsuccinate in the treatment of impetigo in children. " 11/01/1988 - "Results from this study demonstrate that mupirocin is as effective as systemic erythromycin ethylsuccinate for treatment of pyoderma and impetigo." 12/01/1988 - "Sixty-two children aged 5 months to 13 years with impetigo were assigned to be treated with either mupirocin in three daily applications or erythromycin ethylsuccinate (40 mg/kg of body weight per day divided into four doses) according to a randomized treatment schedule. " 05/01/1990 - "The results of the trial indicate that 2% mupirocin ointment is as safe and effective as oral erythromycin ethylsuccinate in the treatment of patients with impetigo." 05/01/1990 - "Sixty patients participated in a bacteriologically controlled, randomized, parallel group comparison of 2% mupirocin ointment (Bactroban) and oral erythromycin ethylsuccinate for the treatment of impetigo. "
9.	Hydrogen Peroxide (Hydroperoxide)FDA LinkGeneric 11/01/1994 - "Hydrogen peroxide cream: an alternative to topical antibiotics in the treatment of impetigo contagiosa." 02/02/2022 - "This protocol for a non-inferiority, single-blind randomised controlled trial compares topical fusidic acid with topical hydrogen peroxide and with simple wound care in the treatment of childhood impetigo. " 02/02/2022 - "Alternative treatments are urgently being sought, and as impetigo is a superficial infection, it has been suggested that topical antiseptics such as hydrogen peroxide or simple wound care alone may treat impetigo while avoiding the risk of increased antimicrobial resistance. " 11/09/2021 - "We aimed to determine the feasibility of a randomised controlled trial (RCT) comparing efficacy of soft white paraffin (SWP), hydrogen peroxide (H2O2) and mupirocin for mild impetigo. " 11/01/1994 - "In total, 256 patients with bacteriologically verified impetigo contagiosa were included in three double-blind, parallel group, randomized, multi-centre trials, where the efficacy of hydrogen peroxide cream (Microcid) was compared with that of fusidic acid cream/gel (Fucidin). "
10.	Local Anti-Infective Agents (Antiseptics)IBA 01/01/2022 - "Twenty guidelines (39%) did not mention antiseptic treatment for impetigo. " 08/01/2007 - "Consequently, there will be risk of the emergence of C-MRSA with decreased antiseptic susceptibility among patients with impetigo." 06/01/2006 - "Therefore, it was concluded that the lower distribution rate of qacA/B resulted in higher susceptibilities to cationic antiseptic agents in MRSA isolated from patients with impetigo and SSSS." 06/01/2006 - "The susceptibilities to antiseptic agents in MRSA isolates from patients with impetigo and SSSS were higher than those in MRSA isolates from patients with other diseases. " 02/01/2018 - "To successfully treat impetigo into the future and ensure that therapy does not contribute to bacterial resistance, additional research is required to ascertain the usefulness of alternative agents, including new topical antimicrobials and antiseptics."

Therapies and Procedures

1.	Therapeutics 01/01/2020 - "Further studies with real-life analyses and pharmacoeconomic evaluation are needed to confirm its role as first-line and second-line therapy in children with impetigo." 01/01/2023 - "Several criteria have to be considered when selecting topical antibacterial therapy for impetigo. " 12/15/2020 - "This review discusses the current impetigo treatment challenges in endemic settings in Australia and explores potential alternative antimicrobial therapies. " 10/01/2020 - "Treatment for limited impetigo is topical whereas oral therapy is recommended for extensive cases. " 03/01/2020 - "Healthcare providers should be aware of local resistance patterns in impetigo to help guide therapy. "
2.	Mass Drug Administration 01/01/2021 - "Mass drug administration intervention emerged as a promising public health strategy to reduce the prevalence of impetigo in endemic settings. " 01/01/2022 - "Mass drug administration (MDA) has been reported in several studies to reduce the prevalence of scabies and impetigo. " 12/01/2020 - "Community perspectives on scabies, impetigo and mass drug administration in Fiji: A qualitative study." 01/01/2021 - "Mass drug administration campaigns for scabies and impetigo: protocol for a systematic review and meta-analysis." 12/01/2020 - "Thematic analysis examined participants' lived experiences of scabies and impetigo; community knowledge and perceptions about scabies and impetigo aetiology and transmission; community-based treatment and prevention measures; and attitudes towards mass drug administration. "
3.	Blood Component Removal (Apheresis) 03/01/2020 - "Impetigo herpetiformis with a CARD14 Thr79Ile variant successfully treated with granulocyte and monocyte adsorption apheresis." 01/01/2018 - "Granulocyte/Monocyte Adsorption Apheresis as a Novel Therapeutic Approach in the Treatment of an Impetigo Herpetiformis Case." 10/01/2017 - "Impetigo Herpetiformis Complicated with Intrauterine Growth Restriction Treated Successfully with Granulocyte and Monocyte Apheresis."
4.	Injections 09/01/1985 - "A number of well-designed comparison studies have shown the superiority of oral or injectable antibiotics over typical treatment in the treatment of impetigo contagiosa. " 12/15/2020 - "In remote settings in Australia, topical antibiotics are no longer used for impetigo due to the troubling rise of antimicrobial resistance, demanding the use of oral and injectable antibiotic therapies. "
5.	Traditional Medicine (Folk Remedies) 01/01/2017 - "In fact, in Mediterranean countries, lentisk oil still continues to be widely used in folk medicine for oral and skin affections, in particular, acute gingivitis, pediatric skin infections such as impetigo and foot plaques, and biofilm related infections often associated with Streptococcus spp. Following these observations, we have hypothesized a "lentisk oil-bacteria" interaction, placing particular emphasis on the different Streptococcal species involved in these oral and skin diseases. " 11/01/2020 - "Other dermatoses treated by indigenous products included impetigo and other bacterial infections, seborrheic dermatitis, dermatophytoses, verruca, molluscum, hypopigmentary disorders, etc. In Indian setup, home remedies are commonly used by the caregivers before visiting a dermatologist to treat various pediatric dermatoses."