Short-Course Co-Trimoxazole for Impetigo Treatment

Oral co-trimoxazole was noninferior to intramuscular benzathine benzylpenicillin for improving or healing lesions in 7 days.

Impetigo afflicts over 100 million children worldwide. In remote, indigenous Australia, the prevalence is 10% to 70%, and severity gauged by numbers of lesions is high. Intramuscular benzathine benzylpenicillin effectively treats impetigo in tropical, high-prevalence settings, but injections are painful, and resistant strains of Staphylococcus aureus are unaffected.

In a noninferiority, open-label study, 508 children with severe impetigo (>5 lesions) were randomized to a single intramuscular benzathine benzylpenicillin injection, oral co-trimoxazole (trimethoprim/sulfamethoxazole) daily for 5 days, or oral co-trimoxazole, a half dose twice daily for 3 days. Lesions were photographed at 0, 2, and 7 days; reviewers were blinded to which of a p…

Reviewing Author

Mark V. Dahl, MD

Disclosures

Consultant / Advisory board Ulthera, Inc.; AuBio LifeSciences, LLC; Paris Therapeutics

Equity Elorac, Inc.; Makucell, Inc.; Paris Therapeutics

Editorial boards UpToDate

Leadership positions in professional societiesNational Rosacea Society (Chairman, Medical Board)