Impetigo

L01.0-1

DESCRIPTION

A common contagious skin infection caused by streptococci or staphylococci.
Predominantly occurs in children.
Often secondary to scabies, insect bite, eczema or tinea capitis .
Clinical features:

  • starts as blisters containing pus
  • subsequently becomes eroded producing honey-coloured crusts
  • commonly starts on the face or buttocks
  • spreading to neck, hands, arms and legs

Note:

  • Post-streptococcal glomerulonephritis is a potential complication.
  • Check urine for blood if the sores have been present for more than a week.

GENERAL MEASURES

  • Good personal and household hygiene to avoid spread of the infection and to reduce carriage of organisms.
  • Trim finger nails.
  • Wash and soak sores in soapy water to soften and remove crusts.
  • Continue with general measures until the sores are completely healed

MEDICINE TREATMENT

  • Povidone iodine 5%, cream or 10% ointment, apply 8 hourly.

AND

Children ≤ 7 years of age

OR

Children > 7 years of age and adults

  • Cefalexin , oral, 500 mg 6 hourly for 5 days.

OR

  • Flucloxacillin, oral, 500 mg 6 hourly for 5 days.

Severe penicillin allergy: Z88.0

Children

Adults

  • Macrolide, e.g.:
  • Azithromycin, oral, 500 mg daily for 3 days.

If impetigo has improved, but has not completely cured, give a 2nd 5-day course of antibiotics.

REFERRAL

  • No improvement after second course of antibiotics.
  • Presence of blood on urine test strip for longer than 5-7 days.
  • Clinical features of glomerulonephritis. See: Nephritic syndrome