How to Treat Impetigo in Children

Impetigo will usually go away on its own. When it doesn’t, anti­biotics can be used to help kill the bacteria. For isolated spots of impetigo, you can use a topical antibiotic cream or ointment. Many different types are sold over the counter, including Neo-sporin, bacitracin, and triple antibiotic ointment. If one of these does not help, your doctor may prescribe a stronger topical anti­biotic, such as mupirocin (Bactroban).

Generally speaking, antibiotic ointments work better than creams because the medicine penetrates more deeply. However, creams tend to be less greasy.

Oral antibiotics are used to treat impetigo that has spread to distant places on the body. Oral antibiotics also are used for impetigo that is located inside the nose or mouth, since these areas cannot be treated with topical antibiotics. Finally, oral antibiotics are used for rashes that are not improving — or that are getting worse — despite the use of topical antibiotics. The most common classes of oral antibiotics used to treat impetigo are penicillins, cephalosporins, and sulfa drugs.

When does my doctor need to be involved?

Your doctor should see your child if the impetigo is getting worse in one particular area, continuing to spread, or not getting better after two to three weeks. If your child is complaining of signifi­cant pain associated with the impetigo, have your doctor take a look. Anytime a child has a fever associated with impetigo, a doc­tor should evaluate the child.

What tests need to be done, and what do the results mean?

Tests rarely need to be done. It is quite obvious to most clinicians what is causing this distinct rash.

If there is concern that the bacteria have moved into the blood­stream, a complete blood count and a blood culture may be done. This is highly unusual with impetigo.

What are the possible complications?

If treated appropriately, run-of-the-mill impetigo will not cause scarring. However, it can leave a scar, especially if your child scratches often. Generally speaking, the scars are very subtle.

Rarely, the bacteria causing impetigo spread to distant parts of the body. This can cause bigger problems, such as infection of the bloodstream (bacteremia), the lungs (pneumonia), or, in very rare cases, the entire body (sepsis). It should be empha­sized that these types of spreading infections are uncommon with impetigo.

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