Management Of Impetigo Research Articles

Ozenoxacin: A novel topical quinolone

The burden of dermatological conditions is huge on the global health accounting for 44.1 million DALYs worldwide. Impetigo is a highly contagious bacterial infection with 2.5 time’s greater likelihood in pediatrics (12.3%) than in adults (4.9%). Micro-organisms causing impetigo include bacteria like or both. The management of Impetigo is with topical and systemic antimicrobial agents. Topical antimicrobial resistance is on the rise in patients with Impetigo. Therefore, there is clearly a need for newer antimicrobials having different mode of action and showing good activity against non-responding strains in the management of impetigo. Ozenoxacin is a novel, topical quinolone with a good safety and tolerability profile in the management of Impetigo. The authorizing bodies namely USFDA, European Medical Agency, and DCGI have approved the use of Ozenoxacin 1% cream for the topical treatment of impetigo due to in adult and pediatric patients 2 months of age and older.

Prevalence and Associations of General Practice Registrars' Management of Impetigo: A Cross-Sectional Analysis From the Registrar Clinical Encounters in Training (ReCEnT) Study.

Impetigo is a mild bacterial skin infection of childhood that is usually managed empirically in primary care. To establish the prevalence and associations of impetigo in general practice (GP) registrars' consultations. Cross-sectional analysis of the Registrar Clinical Encounters in Training (ReCEnT) study data. Impetigo was managed in 0.24% of problems and 0.43% of consultations. Patient variables associated with impetigo presentations were younger age and impetigo as a new problem, while patients with non-English-speaking backgrounds were less likely to present with impetigo. Associated registrar variables were being new to the registrar and practicing in outer regional/remote locations. Compared with all other problems/diagnoses, impetigo more often involved information seeking, ordering pathology, and prescription of medication, but less often involved follow-up or referral. Impetigo accounts for 0.43 per 100 GP registrar consultations in Australia. Association with outer regional/remote areas may reflect climate and socioeconomic factors that predispose to impetigo. Associated pathology requests may reflect a lack of confidence in GP registrars' management of impetigo. Cultural differences may exist regarding health-seeking behavior relating to impetigo.

Antibiotic stewardship in skin infections: a cross-sectional analysis of early-career GP’s management of impetigo

ObjectiveTo establish the prevalence and associations of systemic antibiotic prescription for impetigo by early-career general practitioners (GPs) (GP registrars in their first 18 months in general practice).DesignA cross-sectional analysis of...

AKT question relating to management of impetigo

AKT question relating to management of impetigo

AKT answer relating to management of impetigo

AKT answer relating to management of impetigo

Diagnosis and management of impetigo.

Impetigo, a bacterial skin infection that involves the superficial layers of the skin, is one of the most common skin infections in children ages 2 to 5 but can occur in individuals across the lifespan. This article discusses the diagnosis and management of impetigo in primary care.

Inhibition of Streptococcus pyogenes growth by native Australian plants: New approaches towards the management of impetigo, pharyngitis and rheumatic heart disease

Introduction: Streptococcus pyogenes can cause a variety of diseases including streptococcal pharyngitis, impetigo and rheumatic heart disease, dependant on which tissue it infects. Many Australian plants have documented therapeutic properties as general antiseptics, but are yet to be tested for the ability to inhibit S. pyogenes growth. Methods: Solvent extracts were prepared using Australian plants with documented ethnobotanical usage to treat bacterial infections, or published antibacterial activity. The extracts were investigated by disc diffusion assay for the ability to inhibit the growth of a clinical strain of S. pyogenes. Their MIC values were determined to quantify and compare their efficacies. Toxicity was determined using the Artemia franciscana nauplii bioassay. Results: S. pyogenes growth was inhibited by 24 of the 34 extracts tested. The Eucalyptus spp. extracts were particularly potent. MIC values of 341 and 88 μg/ mL were determined for the aqueous and methanolic E. baileyana extracts respectively. Similarly, MIC values of 134 and 53 μg/mL were determined for the aqueous and methanolic E. major extracts respectively. The methanolic wattle seed extract, aqueous and methanolic lemon aspen extracts, aqueous native thyme extract, methanolic river mint extract and the methanolic native basil extract were similarly potent growth inhibitors, with MIC values ≤1000 μg/mL. Several other extracts (methanolic native tamarind, bush tomato, desert lime, native thyme, native sage and the T. stipitata leaf extracts, as well as the aqueous river mint, native basil, T. stipitata leaf extracts) displayed moderate growth inhibitory activity (MIC=1000-5000 μg/mL). All other extracts were either low potency S. pyogenes growth inhibitors or were devoid of inhibitory activity. The E. baileyana and E. major methanolic extracts, as well as the E. baileyana aqueous extract induced significant mortality in the Artemia fransiscana bioassay, with LC50 values substantially 1000 μg/mL. Conclusion: The potent growth inhibitory bioactivity of the Eucalyptus spp., lemon aspen, wattle seed, native basil and river mint extracts against S. pyogenes demonstrates their potential for the treatment and prevention of S. pyogenes induced disease. However, the toxicity of the Eucalyptus spp. extracts may limit their use to topical treatments for pharyngitis and impetigo. As the lemon aspen, wattle seed, native basil and river mint extracts were nontoxic, they may also have wider uses in treating systemic illnesses such as rheumatic fever, rheumatic heart disease and cellulitis.

Clinical and bacteriological efficacy of twice daily topical retapamulin ointment 1% in the management of impetigo and other uncomplicated superficial skin infections.

BackgroundCutaneous bacterial infections are common in children and adults and frequently are caused by Staphylococcus aureus (S. aureus). Treatment failures with topical agents are not uncommon and have been shown to be secondary to bacterial resistance.ObjectiveTo determine clinical and bacteriological efficacy of retapamulin ointment 1% in treatment of patients with cutaneous bacterial infections caused by methicillin-resistant S. aureus (MRSA) and other bacteria.MethodsProspective, nonrandomized, uncontrolled, open label, single center trial conducted between April 2008 and November 2012 that evaluated efficacy of retapamulin ointment 1% in the treatment of impetigo, folliculitis, and other minor soft tissue infections in children and adults. Fifty patients, who presented to a dermatology outpatient clinic and were clinically diagnosed with impetigo, folliculitis, or minor soft tissue infection suitable for treatment with a topical antibiotic, were screened. Thirty-eight patients were enrolled and received treatment: topical retapamulin ointment 1% twice daily for 5 days. Seven patients were MRSA positive and qualified for the primary efficacy population. One patient withdrew due to an adverse event. Clinical and microbiological exams were performed at baseline and follow-up 5 to 7 days later to assess clinical, microbiological, and therapeutic responses. Primary outcome was clinical response at follow-up in primary efficacy population with MRSA isolated as the baseline pathogen. Secondary outcomes included clinical, microbiologic, and therapeutic responses in patients who were culture positive for any species of bacteria.ResultsClinical response at follow-up in the primary efficacy population (MRSA-positive patients) was not sufficiently powered to demonstrate significance; however, outcomes were excellent, with 7 of 7 patients demonstrating clinical success (5 of 7) or clinical improvement (2 of 7) at follow-up. Barring lack of significance due to small total sample size for patients who were culture positive for any species of bacteria (n = 35), overall success rates were favorable for clinical, microbiologic, and therapeutic responses with values of 66%, 97%, and 69%, respectively. Adverse events (AEs) were mild or moderate in severity. No serious AEs were reported.ConclusionSafety profile appears favorable given the low number of AEs. Study design limits conclusions that can be drawn. Nevertheless, this study supports use of topical retapamulin 1% ointment in treatment of cutaneous bacterial infections, particularly those caused by S. aureus, including MRSA.

Impetigo - review.

Impetigo is a common cutaneous infection that is especially prevalent in children. Historically, impetigo is caused by either group A β-hemolytic streptococci or Staphylococcus aureus. Currently, the most frequently isolated pathogen is S. aureus. This article discusses the microbiologic and virulence factors of group A β-hemolytic streptococci and Staphylococcus aureus, clinical characteristics, complications, as well as the approach to diagnosis and management of impetigo. Topical agents for impetigo therapy are reviewed.

Retapamulin

Topical retapamulin (Altabax, Altargo) is the first pleuromutilin antibacterial approved for the treatment of uncomplicated superficial skin infections caused by Staphylococcus aureus (excluding meticillin-resistant S. aureus [MRSA]) and Streptococcus pyogenes in patients aged > or = 9 months. In the EU, retapamulin is indicated for use in patients with impetigo or with infected small lacerations, abrasions or sutured wounds (without abscesses); in the US, it is indicated for use in patients with impetigo. Retapamulin has a novel site of action on bacterial ribosomes. In clinical trials in patients with impetigo, topical retapamulin 1% ointment twice daily for 5 days (the approved regimen) was superior to placebo; treatment with retapamulin was noninferior to that with topical fusidic acid. In patients with secondarily infected traumatic lesions, treatment with retapamulin was noninferior to that with oral cefalexin, although the efficacy of retapamulin was reduced in patients with MRSA infections or superficial abscesses. Retapamulin was well tolerated in both paediatric and adult patients, and the majority of adverse events were of mild to moderate severity. Thus, the introduction of topical retapamulin 1% ointment extends the treatment options available in the management of impetigo and uncomplicated secondarily infected traumatic lesions.

Spotlight on Retapamulin in Impetigo and Other Uncomplicated Superficial Skin Infections†

Topical retapamulin (Altabax, Altargo) is the first pleuromutilin antibacterial approved for the treatment of uncomplicated superficial skin infections caused by Staphylococcus aureus (excluding methicillin-resistant S. aureus [MRSA]) and Streptococcus pyogenes in patients aged > or = 9 months. In the EU, retapamulin is indicated for use in patients with impetigo or with infected small lacerations, abrasions, or sutured wounds (without abscesses); in the US, it is indicated for use in patients with impetigo. Retapamulin has a novel site of action on bacterial ribosomes. In clinical trials in patients with impetigo, topical retapamulin 1% ointment twice daily for 5 days (the approved regimen) was superior to placebo; treatment with retapamulin was noninferior to that with topical fusidic acid. In patients with secondarily infected traumatic lesions, treatment with retapamulin was noninferior to that with oral cephalexin, although the efficacy of retapamulin was reduced in patients with MRSA infections or superficial abscesses. Retapamulin was well tolerated in both pediatric and adult patients, and the majority of adverse events were of mild to moderate severity. Thus, the introduction of topical retapamulin 1% ointment extends the treatment options available in the management of impetigo and uncomplicated secondarily infected traumatic lesions.

Impetigo: An Overview

This article reviews in detail the pathogenesis, clinical characteristics and management of impetigo in children. Impetigo is the most common bacterial skin infection of children. Most cases of nonbullous impetigo and all cases of bullous impetigo are caused by Staphylococcus aureus. The remainder of cases of nonbullous impetigo are due to group A beta hemolytic streptococci (GABHS). GABHS colonize the skin directly by binding to sites on fibronectin that are exposed by trauma. In contrast, S. aureus colonizes the nasal epithelium first; from this reservoir, colonization of the skin occurs. Patients with recurrent impetigo should be evaluated for carriage of S. aureus. Superficial, localized impetigo may be treated successfully in more than 90% of cases with topical application of mupirocin ointment. Impetigo that is widespread or involves deeper tissues should be treated with a beta-lactamase-resistant oral antibiotic. The choice of antibiotics is affected by the local prevalence of resistance to erythromycin among strains of S. aureus, antibiotic cost and availability, and issues of compliance.