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August 1989

Topical Mupirocin Treatment of Impetigo Is Equal to Oral Erythromycin Therapy

Author Affiliations

From the Department of Dermatology and Cutaneous Surgery, University of Miami (Fla) School of Medicine (Ms Mertz, Mr Marshall, and Dr Eaglstein); and the Department of Public Health of the City of San Juan, Puerto Rico (Drs Piovanetti and Montalvo).

Arch Dermatol. 1989;125(8):1069-1073. doi:10.1001/archderm.1989.01670200045006

• Topical antimicrobial therapy has not been effective in the past against cutaneous bacterial infections. In this study, a new topical antibiotic ointment, mupirocin, was compared with oral erythromycin ethylsuccinate in the treatment of impetigo. Seventy-five patients clinically diagnosed as having impetigo and with positive cultures of Staphylococcus aureus, Streptococcus pyogenes, or both were examined in an investigator-blinded study. Patients used topical mupirocin applied three times daily or the usual oral dose of erythromycin ethylsuccinate (30 to 50 mg/kg per day). Patients' lesions were examined clinically and cultured bacteriologically on days 0, 3, and 8, and 1 week after treatment. Susceptibility testing was performed on pathogens isolated to determine antibiotic resistance. Mupirocin treatment produced similar clinical results to oral erythromycin and was superior in the eradication of S aureus, including antibiotic-resistant S aureus. These results show topical mupirocin to be a safe and effective alternative to oral antibiotic therapy in the treatment of impetigo.

(Arch Dermatol. 1989;125:1069-1073)