Mupirocin Treatment for Impetigo

Dosing and Administration

• The American Academy of Pediatrics and Infectious Diseases Society of America recommend applying mupirocin 2% ointment to the affected areas three times daily for 5 days for impetigo treatment in children 1, 2
• The treatment duration for impetigo with mupirocin is 5 days 2

Topical vs. Oral Therapy

• Mupirocin is appropriate for children with a limited number of lesions, not part of an outbreak, and with localized infection 1, 2, 3
• Oral antibiotics should be considered if numerous lesions are present, there is an outbreak, or no clinical response occurs within 3-5 days of topical therapy 2

Oral Antibiotic Alternatives

• The Infectious Diseases Society of America recommends oral antibiotic regimens including cephalexin 25-50 mg/kg/day, dicloxacillin 25-50 mg/kg/day, or clindamycin 10-20 mg/kg/day for 7 days if oral therapy is necessary 2, 3, 4
• Clindamycin should be considered if MRSA is suspected or confirmed, with a resistance rate less than 10% 1, 2
• Tetracyclines, such as doxycycline and minocycline, should be avoided in children under 8 years of age 1, 5, 6

Diagnostic Considerations

• Culture and Gram stain can help identify the cause of impetigo, but treatment without these studies is reasonable in typical cases 2
• If MRSA is suspected or confirmed, oral options include clindamycin, TMP-SMX, or continued mupirocin topical treatment for limited disease 1, 2