Impetigo: What can make it go away faster?
Research has shown that milder cases of impetigo go away faster when they're treated with particular antibiotic creams. It isn't clear whether antiseptic solutions or creams can help.
Impetigo is a skin infection that is usually itchy and sometimes painful, and is most common in children. It is caused by bacteria and is highly contagious. Left untreated, it usually clears up on its own within a few weeks – but there's a risk of infecting other people until it does. Antibiotic creams are often used in order to make the symptoms go away faster and stop the infection from spreading. Antibiotic tablets may be used if the impetigo has spread over larger areas of skin. All antibiotic medications have to be prescribed by a doctor.
Research on how effective the different treatments are
To compare the effectiveness of different treatment options, researchers from the Cochrane Collaboration (an international network of researchers) looked for and systematically analyzed all the relevant studies in this area. These studies looked at the effectiveness of antiseptic or antibiotic solutions and creams, as well as antibiotic tablets, in the treatment of impetigo. Most of this research only looked at people who had impetigo on smaller areas of skin – so their symptoms affected a limited area.
The studies showed that creams containing antibiotic medication – such as mupirocin, fusidic acid or retapamulin – relieved the symptoms better than ointments that didn't contain any antibiotic medication. Mupirocin cream was the most commonly tested antibiotic. The studies on mupirocin found the following:
- Without treatment: Symptoms improved or cleared up after 7 to 12 days in about 35 out of 100 people who used a placebo (fake medication).
- With treatment: Symptoms improved or cleared up after 7 to 12 days in about 75 out of 100 people who used the mupirocin cream.
In other words: Treatment with mupirocin cream helped impetigo clear up faster in 40 out of 100 people.
Only about 170 people participated in the studies, though, so the figures only allow a rough estimate of what can be expected from antibiotic creams.
Mupirocin cream was also somewhat more effective than tablets containing the antibiotic erythromycin (in the treatment of impetigo that covered smaller areas of skin). Erythromycin tablets were also more likely to cause side effects such as nausea, vomiting, stomach ache and diarrhea. In the studies, about 25 out of 100 people who took the erythromycin tablets had these kinds of side effects, but only 5 out of 100 people who used mupirocin cream did.
None of the studies were suitable for answering the question of whether antibiotic tablets are more effective than antibiotic creams when treating impetigo affecting larger or several areas of the body. It is also not clear if antiseptic solutions or creams can help in the treatment of impetigo.
Koning S, van der Sande R, Verhagen AP, van Suijlekom-Smit LW, Morris AD, Butler CC et al. Interventions for impetigo. Cochrane Database Syst Rev 2012; (1): CD003261.
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