Sir.—Issues relating to the management of impetigo, a common pediatric problem, continue to be discussed in these pages.1,2 Although orally administered antibiotics have been considered optimal therapy for many years, the advent of a novel topical antibiotic, mupirocin, has prompted several clinical trials comparing the efficacy, compliance, cost, and safety of these two treatment modalities. In many of these trials, erythromycin has been used as the prototypic oral agent.3-6
We recently completed a study of 48 patients with impetigo randomized to receive mupirocin or erythromycin therapy. Twenty-five children received mupirocin and 23, erythromycin. We were interested not only in the comparative efficacy of these drugs, but also in the microbiologic data and antibiotic sensitivities of the bacteria cultured, as recent studies have suggested that Staphylococcus aureus is now the most common cause of impetigo and that a large number of these strains may be resistant to erythromycin.
ESTERLY NB, NELSON DB, DUNNE WM. Impetigo. Am J Dis Child. 1991;145(2):125-126. doi:10.1001/archpedi.1991.02160020015003