The golden crusts and/or superficial blistering of impetigo are usually characteristic. Always take moist swabs to confirm the diagnosis and to check bacterial sensitivity. Topical treatment is adequate for limited impetigo, but if widespread, systemic antibiotics are also required. If recurrent attacks occur. remember to swab the nares for Staph carriage which is often not eliminated by systemic antibiotics and requires topical treatment, eg: Naseptin or Bactraban Nasal. It is often worth swabbing the nares of family members.

For most cases of impetigo topical Fucidin is effective. Alternatives are Neomycin, Mupirocin and Bactroban. Mupirocin should not be used routinely as it is such an important topical antibiotic for use in neo-natal units and we are keen not to induce resistance.

For more extensive disease, use oral antibiotics such as penicillin and flucloxacillin, or erythromycin.

Crusts and scabs must be manually removed whilst bathing eg with dermol 500, aqueous cream.