title: Impetigo contagiosa III. Comparative efficacy of oral erythromycin and topical mupirocin.
abstract: Ninety-seven patients with impetigo were prospectively enrolled in a study to determine the comparative efficacy of systemic and topical antibiotic therapy. After obtaining a bacterial culture from a representative lesion, the children were randomized to receive seven days of either oral erythromycin or topical mupirocin administered three times daily. Staphylococcus aureus alone was isolated from 51% and in association with group A beta-hemolytic streptococci (GABS) from 29%; GABS alone was isolated from 4% of patients. Of 48 children who received erythromycin, 43 (90%) were clinically improved or cured, and 11 of 17 were bacteriologically cured. Of 49 children who received mupirocin, 47 (96%) were clinically improved or cured, and 10 of 14 were bacteriologically cured. At three-week follow-up, clinical cure rates and number of secondary household cases of impetigo were equivalent in both treatment groups. Mupirocin appears to be a well-tolerated, albeit expensive, alternative to erythromycin for the treatment of impetigo.
authors.affiliation: St. Louis University School of Medicine, Department of Pediatrics/Adolescent Medicine, Missouri.
authors.forename: L L
authors.initials: LL
authors.lastname: Barton
authors.forename: A D
authors.initials: AD
authors.lastname: Friedman
authors.forename: A M
authors.initials: AM
authors.lastname: Sharkey
authors.forename: D J
authors.initials: DJ
authors.lastname: Schneller
authors.forename: E M
authors.initials: EM
authors.lastname: Swierkosz
mesh_terms: D000284:Administration, Oral; D000287:Administration, Topical; D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D004352:Drug Resistance, Microbial; D004917:Erythromycin / Q000008:administration & dosage / Q000009:adverse effects / Q000378:metabolism / Q000627:therapeutic use*; D005227:Fatty Acids / Q000008:administration & dosage / Q000009:adverse effects / Q000378:metabolism / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007169:Impetigo / Q000188:drug therapy* / Q000473:pathology; D007223:Infant; D008297:Male; D016712:Mupirocin; D011446:Prospective Studies; D011897:Random Allocation; D013211:Staphylococcus aureus / Q000302:isolation & purification; D013291:Streptococcus / Q000302:isolation & purification
chemical_list: D000900:Anti-Bacterial Agents; D005227:Fatty Acids; D004917:Erythromycin; D016712:Mupirocin