Impetigo

NICE Clinical Knowledge Summaries - Impetigo

Impetigo is usually a self-limiting infection which usually heals in 1-3 weeks without treatment

Impetigo is usually a clinical diagnosis, and investigations are not routinely needed.

Do not take a swab unless there widespread infection or failure/recurrence despite appropriate hygiene measures and empirical treatment as below.

Preferred treatments:

Localized non-bullous impetigo and not systemically unwell or at risk of complications: Hydrogen peroxide 1% cream

H2O2 not suitable OR widespread non-bullous impetigo and not systemically unwell/at risk of complications: Topical Fusidic acid  (Mupirocin is another topical treatment option if suspected/confirmed Fusidic acid resistance)

Localised/widespread lesions but more systemically unwell OR bullous impetigo: Oral antibiotic

Adults and children aged 2 years or older with minor skin infection can be referred to their local community pharmacy for topical fusidic acid treatment.