Interventions for impetigo

Koning, Sander; Sande, Renske van der; Verhagen, Arianne P.; Suijlekom-Smit, Lisette WA van; Morris, Andrew D.; Butler, Christopher Collett; Berger, Marjolein Y.; Wouden, Johannes C van der

doi:10.1002/14651858.cd003261.pub3

Cited by 99 publications

(89 citation statements)

References 112 publications

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“…Although SXT is no longer commonly recommended for treatment of respiratory tract infections, it remains one of the most widely used and cheapest antibacterials in the world and is an important option for treatment of SSTI, where S. pyogenes and S. aureus are often copathogens (4,12,24,34). In the era of rising MRSA prevalence, antibacterials that are active against both bacteria are highly valued.…”

Section: Discussionmentioning

confidence: 99%

Is Streptococcus pyogenes Resistant or Susceptible to Trimethoprim-Sulfamethoxazole?

et al. 2012

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Section: Discussionmentioning

confidence: 99%

Is Streptococcus pyogenes Resistant or Susceptible to Trimethoprim-Sulfamethoxazole?

et al. 2012

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“…A 2012 meta-analysis of 68 treatment trials for impetigo (362) concluded that topical antibiotics, including mupirocin, fusidic acid, and retapamulin, are more effective than placebo and as effective as or more effective than oral antibiotics. There was no difference when mupirocin and fusidic acid were compared head-to-head (362). Penicillin was inferior to erythromycin and cloxacillin.…”

Section: Treatmentmentioning

confidence: 99%

Staphylococcus aureus Infections: Epidemiology, Pathophysiology, Clinical Manifestations, and Management

et al. 2015

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SUMMARY Staphylococcus aureus is a major human pathogen that causes a wide range of clinical infections. It is a leading cause of bacteremia and infective endocarditis as well as osteoarticular, skin and soft tissue, pleuropulmonary, and device-related infections. This review comprehensively covers the epidemiology, pathophysiology, clinical manifestations, and management of each of these clinical entities. The past 2 decades have witnessed two clear shifts in the epidemiology of S. aureus infections: first, a growing number of health care-associated infections, particularly seen in infective endocarditis and prosthetic device infections, and second, an epidemic of community-associated skin and soft tissue infections driven by strains with certain virulence factors and resistance to β-lactam antibiotics. In reviewing the literature to support management strategies for these clinical manifestations, we also highlight the paucity of high-quality evidence for many key clinical questions.

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“…Dieses Antibiotikum ist nicht für den systemischen Gebrauch vorgesehen. Diese Empfehlung leitet sich her aus den verfügbaren Evidenzen [11], aber auch aus dem vernünftig-sparsamen Gebrauch wertvoller Ersatzantibiotika [5,6,12]. So hat sich die lokale Anwendung von Mupirocin und Fusidinsäure zwar Die Impetigo contagiosa ist eine primäre, oberflächliche Infektion der Haut (Epidermis) durch beta-hämolysierende Streptokokken oder durch S. aureus.…”

Section: Therapieunclassified

“…Für die kalkulierte orale Therapie bei ausstehender oder fehlender Erregerisolation sind Cefadroxil (1-2 x 1 g/d) oder Cefalexin (3-4 x 1 g/d) -wegen der längeren Halbwertszeit bevorzugen wir Cefadroxil -, Roxithromycin (1 x 0,3 g/d) oder Clarithromycin (2 x 0,5 g/d) zu empfehlen [11,12,16].…”

Section: Therapieunclassified

Frequent bacterial skin and soft tissue infections: diagnostic signs and treatment

Sunderkötter

Becker

2015

J Deutsche Derma Gesell

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Summary Skin and soft tissue infections rank among the most frequent infections worldwide. Classic erysipelas is defined as a non‐purulent infection by beta‐hemolytic streptococci. The typical signs are tender, warm, bright erythema with tongue‐like extensions and early systemic symptoms such as fever or at least chills. Erysipelas always and best responds to penicillin. Limited soft tissue infection or limited cellulitis are the terms we have introduced for infections frequently caused by S. aureus and often originating from chronic wounds or acute trauma. Clinically, they are marked by tender, erythematous swelling which, unlike erysipelas, exhibit a darker red hue and is not always accompanied by fever or chills at onset. Severe cellulitis is a purulent, partially necrotic infection extending to the fascia, with general symptoms of infection, requiring surgical management in addition to antibiotics. It often fulfils criteria of so‐called complicated soft tissue infections according to the definition of the FDA, due to their frequent association with e.g. severe diabetes mellitus, peripheral arterial occlusive disease or severe immunosuppression. In contrast, the rare necrotizing skin and soft tissue infections represent a distinct entity, characterized by rapid progression to ischemic necroses and shock due to special bacterial toxins. Limited cellulitis should be treated with cephalosporins group 1 or 2, or, when S.aureus is the isolated or highly likely causative agent, isoxazolyl‐penicillins (exploiting their minimal selection pressure on other bacteria). For severe cellulitis, initial antibiotic treatment (mostly iv) includes – depending on the location ‐ agents also active against gram‐negative and/or anaerobic bacteria. (e.g. clindamycine, aminopeniclilline with inhibitors of betalaktamase, fluochinolons, cephalosporines group 4). For cutaneous abscesses, drainage presents the therapy of choice. Only under certain conditions additional antibiotic therapy is required. Adherence to the diagnostic criteria and to evidence‐based or consensus‐derived treatment recommendations as presented herein should allow for an antibiotic therapy with a good balance of efficacy, tolerability by patients and low selection pressure for highly resistant bacteria.

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Interventions for impetigo

Abstract: Analysis 5.1. Comparison 5 Non-bullous impetigo: topical (Top) antibiotic (Ab) vs antifungal (Af), Outcome 1 Cure. Analysis 6.1. Comparison 6 Non-bullous impetigo: topical (Top) antibiotic (Ab) + oral (Or) antibiotic (Ab) vs topical (Top)

Cited by 99 publications

References 112 publications

Is Streptococcus pyogenes Resistant or Susceptible to Trimethoprim-Sulfamethoxazole?

Is Streptococcus pyogenes Resistant or Susceptible to Trimethoprim-Sulfamethoxazole?

Staphylococcus aureus Infections: Epidemiology, Pathophysiology, Clinical Manifestations, and Management

Frequent bacterial skin and soft tissue infections: diagnostic signs and treatment

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