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Do Antimicrobial Resistance Patterns Matter?


This study aims to find a treatment algorithm for impetigo.

An international panel of pediatric dermatologists, dermatologists, pediatricians, and pediatric infectious disease specialists used a modified Delphi technique to develop an impetigo treatment algorithm, according to a study published in the Journal of Drugs in Dermatology (JDD).1

Impetigo is a contagious bacterial skin infection. With the concern of antimicrobial resistance rising, the researchers came together to address the treatment of impetigo in pediatric and adult populations. 

The algorithm included:

  • Education and prevention of impetigo
  • Diagnosis and classification
  • Treatment measures
  • Follow-up and distinguishing factors (widespread vs localized outbreak of disease)

The panel defined localized impetigo as impetigo with fewer than 10 lesions and smaller than 36 cm2 area affected in patients of 2 months and older with no compromised immune status. 

The study noted that resistance to oral and topical antibiotics prescribed for the treatment of impetigo such as mupirocin, retapamulin (Altabax; GlaxoSmithKline), and fusidic acid, have been widely reported.

“When prescribing antibiotics, it is essential to know the local trends in antibiotic resistance,” the authors concluded. “Ozenoxacin cream 1% is highly effective against Streptococcus pyogenes (S pyogenes) and Staphylococcus aureus (S aureus), including methycyllin-susceptible and resistant strains (MRSA), and may be a suitable option for localized impetigo.”


1. Schachner LA, Andriessen A, Benjamin LT, et al. Do antimicrobial resistance patterns matter? An algorithm for the treatment of patients with impetigo. J Drugs Dermatol. 2021;20(2):134-142. doi:10.36849/JDD.5745

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