Systemic antibiotics in the treatment of impetigo in children

Cephalexin appears to be effective against impetigo, whereas penicillin V is not

Seventy-three children with impetigo were randomly assigned to receive penicillin V potassium or cephalexin monohydrate, both administered at dosages of 40 to 50 mg/kg per day, or erythromycin estolate administered at a dosage of 30 to 40 mg/kg per day . All drugs were given in three divided doses for 10 days. Treatment failure was defined as persistence of lesions 8 to 10 days after initiation of drug therapy as determined by examiners blinded to the treatment therapies. Forty-five (62%) cultures showed Staphylococcus aureus only, 14 (19%) showed S. aureus and group A beta-haemolytic streptococci, six (8%) showed group A beta-haemolytic streptococci only, and eight (11%) showed no growth or other organisms. Treatment failure occurred in six (24%) of 25 patients treated with penicillin V, one (4%) of 25 patients treated with erythromycin estolate, and no patients treated with cephalexin.

Comment: The quality of evidence is downgraded by imprecise results (only one small trial was included).

The following decision support rules contain links to this evidence summary:

• Cephalexin rather than penicillin V for impetigo

Ədəbiyyat

1. Demidovich CW, Wittler RR, Ruff ME, Bass JW, Browning WC. Impetigo. Current etiology and comparison of penicillin, erythromycin, and cephalexin therapies. Am J Dis Child 1990 Dec;144(12):1313-5.