Treatment of Impetigo and Antimicrobial Resistance
April 2021 | Volume 20 | Issue 4 | Original Article | 366 | Copyright © April 2021
Published online March 10, 2021
Lawrence A. Schachner MD FAAD FAAPa, Charles W. Lynde MD FAADb, Leon H. Kircik MD FAADc, Antonio Torrelo MDd, Daniel Hohl MDe, Pearl Kwong MD PhD FAADf, Vikash Oza MDg, Anneke Andriessen PhDh, Adelaide A. Hebert MD FAAD FAAPi
aDepartment of Dermatology & Cutaneous Surgery, Department of Pediatrics, Leonard M. Miller School of Medicine, University of Miami, FL
bDepartment of Medicine, University of Toronto, Lynde Institut for Dermatology and Lynderm Research, Ontario, Canada
cIchan School of Medicine at Mount Sinai, New York, NY; Indiana University Medical Center, Indianapolis, IN; Physicians Skin Care, PLLC, Louisville, KY; DermResearch, PLLC, Louisville, KY
dDepartment of Dermatology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
eUniversity Hospital Lausanne, Switzerland
gThe Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, NY
hRadboud UMC, Nijmegen and Andriessen Consultants, Malden, The Netherlands
iUTHealth McGovern Medical School, Houston, TX
Methods: The literature searches reviewed the status of AMR to current topical antibiotics in impetigo, current therapeutic behavior, and concordance with antimicrobial stewardship principles. Two international panels convened to discuss the output of the searches, and the results of the panel discussions were used in the development of the manuscript.
Results: The literature search included clinical trials, research studies, clinical guidelines, consensus papers, and reviews (if they provided original data), published between January 2008 and May 2019. The articles were selected based on clinical relevancy of impetigo management, clinical efficacy, and safety of the treatment and antimicrobial resistance. The searches resulted in one-hundred and ninety-eight articles. After applying the eligibility criteria, nineteen articles met inclusion criteria and were considered in the present review.
Conclusions: While published antimicrobial stewardship guidelines have focused on systemic antibiotics, few studies have attempted to evaluate topical antibiotic prescribing practices for impetigo treatment. Many of the topical impetigo treatments currently in use have developed resistance. The appropriate use of topical ozenoxacin can help eradicate impetigo while minimizing AMR.
J Drugs Dermatol. 20(4):366-372. doi:10.36849/JDD.5795