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. 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. On the initial visit, exudate or cleansed infected sites or both were cultured and
therapy was begun. All patients were treated for 8 days. Patients were seen again on days 4 to 5 of
therapy, at the end of
therapy, and 7 days after the end of
therapy. Sites of
infection were comparable between the groups, as were bacteriologic responses. At the first visit, 24 of 30 children in the
mupirocin group and 14 of 32 children in the
erythromycin group were cured or had at least a 75% reduction in size of the lesions. At the end of the study, all 29 of the children in the
mupirocin group who came to follow-up, compared with 27 of 29 in the
erythromycin group, were cured. Side effects were few. Five children in the
erythromycin group developed mild
diarrhea. Thus,
mupirocin appears to be safe and effective in treating
impetigo in children. Our data show a trend toward more rapid clinical response with
mupirocin than with
erythromycin.