Impetigo Treatment

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Impetigo

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Before you start a diagnosis, please read all of the information below.

Impetigo is a contagious bacterial skin infection. It can easily spread to other parts of the body or other people. It stops becoming contagious 48 hours after you start treatment or when the patches dry out. 

Impetigo can either affect healthy skin or broken skin. It, however, most commonly affects broken skin. The most common bacteria responsible include Staphylococcus and Streptococcus. Keep abrasions, cuts and insect bites clean to help avoid an infection. It usually takes 4-10 days for the rash to appear after you have been infected with the bacteria. It usually starts with blisters or red sores. These then usually become crusty patches of skin which can spread and increase in size.

An antibiotic cream such as Fusidic Acid is commonly used to treat the condition. We may prescribe Fusidic Acid if clinically appropriate:

Please see the 'Common Treatments' section below for further information.

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Common Symptoms

The following are possible symptoms you may experience:

  • red swollen area of skin
  • itching around the area
  • pain and tenderness affecting the area
  • fluid filled blisters
  • pus discharging from the area
  • crusty areas

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Common Treatments

Possible treatments we may prescribe if clinically appropriate:

  • Fusidic Acid antibiotic cream (15g) 7-day course (£1.48*) is the treatment of choice
  • Flucloxacillin 250mg four times a day: 7 days (£1.14*) is reserved only for more extensive infection
  • Clarithromycin 250mg twice a day: 7 days (£1.15*) is reserved for more extensive infection when allergic to penicillin

*Prices shown are cost price of the medication, taken from the British National Formulary 2018, and are given as a guideline. Pharmacies will add a dispensing fee to this which will vary considerably, so it is worthwhile phoning around to compare prices. The medication is paid for at your chosen pharmacy. 

Please click on the medication above to read the Patient Information Leaflet for important information about each drug. We use national prescribing guidelines to select which treatment would be most appropriate for your condition.

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Risk Factors

Risk factors for impetigo include:

  • atopic eczema
  • insect bites,
  • trauma to the skin
  • scabies
  • chickenpox
  • burns
  • contact dermatitis
Self-help for the symptoms

Speak to your pharmacist for advice on over the counter treatments that may help such as creams and painkillers.

  • Wash your hands before and after touching the area and avoid scratching it to reduce the risk of infection. Wash your hands frequently.
  • Keep sores, blisters and crusty patches clean and dry.
  • Cover the areas with loose clothing or gauze bandages.
  • Keep all surfaces you touch clean with disinfectant.
  • Wash your bed linen, clothes and towels at a high temperature.
  • Avoid sharing towels or sheets.
  • Avoid any direct contact with the affected area and others.
  • If the area is painful, then take painkillers, such as paracetamol or ibuprofen. Please read the information leaflet contained with the medication to check it's suitability or speak to your pharmacist if you are unsure.
Information about Fusidic acid

The antibiotic cream Fusidic Acid can be used to treat skin infections. Before you start the treatment, please read the manufacturers leaflet contained with the medication. This contains more information and lists all the potential side effects.

Apply the cream to the affected area three times a day. Wash your hands well after use to stop the spread of infection. Your skin should improve within a few days. If you think your treatment is not working after this time then you should let your doctor know. This could be because your infection is resistant to a particular bacteria and an alternative antibiotic may be required. 

Keep using the cream until the full course is finished (unless a doctor tells you to stop), even if you feel that the infection has cleared up. This is to stop the infection from coming back. 

Never give your medication to other people even if their condition appears to be the same as yours.

Possible side effects

Most types of medicines can cause potential side effects. However, not everyone will experience them.  

Fusidic acid skin preparations may occasionally cause irritation, although this is usually mild and not troublesome.

If any skin irritation becomes troublesome then stop using the cream, contact us, or speak with your doctor or pharmacist. 

Information about Flucloxacillin

The antibiotic Flucloxacillin can be used to treat skin infections if you are not allergic to penicillins. Before you start treatment, always read the manufacturers leaflet contained with the medication. This contains more information and lists all the potential side effects.

The dose is to be taken four times a day, it is important that you space out the doses evenly during the day. Swallow the capsule with water, and take it on an empty stomach. This means an hour before food or 2 hours after food. 

Do not take Flucloxacillin if you are allergic to Penicillin.

Keep taking Flucloxacillin until the full course is finished (unless a doctor tells you to stop), even if you feel that the infection has cleared up. This is to stop the infection from coming back. If you forget to take a dose, take one as soon as you remember unless it's nearly time for your next dose. In this case, just leave out the missed dose and take your next dose as normal.

Never give your medication to other people even if their condition appears to be the same as yours.

Possible side effects of flucloxacillin

Most types of medicines can cause potential side effects. However, not everyone will experience them. The side effects often improve as your body adjusts to the new medicine, but if any of them continue or become troublesome then speak with your doctor or pharmacist. 

The most common ones for Flucloxacillin include:

  • feeling sick (nausea) or vomiting
  • diarrhoea
  • redness and itching in the mouth or genital area (thrush)
  • a skin rash
Information about Clarithromycin

The antibiotic Clarithromycin can be used to treat a skin infection if you are allergic to penicillins. Before you start treatment always read the manufacturers leaflet contained with the medication, which contains more information and the potential side effects.

The dose is to be taken twice a day; it is important that you space out the doses evenly during the day. Swallow the tablet with water, and you can take Clarithromycin either before or after your meals.

Keep taking Clarithromycin until the full course is finished (unless a doctor tells you to stop), even if you feel that the infection has cleared up. This is to stop the infection from coming back. If you forget to take a dose, take one as soon as you remember unless it's nearly time for your next dose. In this case, just leave out the missed dose and take your next dose as normal.

Never give your medication to other people even if their condition appears to be the same as yours.

Possible side effects from clarithromycin

Most types of medicines can cause potential side effects. However, not everyone will experience them. The side effects often improve as your body adjusts to the new medicine, but if any of them continue or become troublesome then contact us, or speak with your doctor or pharmacist. 

The most common ones (occur in about 1 in 10 people) for Clarithromycin include:

  • feeling sick (nausea) or vomiting
  • diarrhoea
  • redness and itching in the mouth or vagina (thrush)
  • tooth or tongue discolouration, and changes in the way things taste or smell. This will settle once you finish treatment.
  • a headache

Who should not take clarithromycin

It is important that you tell your doctor in your assessment of all the medical conditions you have, and all the medications you take. Failure to do so can lead to problems with any treatment you are prescribed. Always read the patient leaflet before you take any medication. 

The following groups of people should not take Clarithromycin:

  • those allergic to clarithromycin or macrolide antibiotics
  • those with QT prolongation or ventricular cardiac arrhythmia, including torsades de pointe
  • those with heart disease
  • those with hypokalaemia (low potassium)
  • those with problems with the way your liver works
  • pregnant women or if breastfeeding 

The following medications can interact with Clarithromycin:

  • Statin for lowering cholesterol: you should stop your statin while you are taking Clarithromycin.
  • Colchicine used for gout: clarithromycin should not be taken if you are also taking colchicine. 
  • Warfarin: Clarithromycin can increase the bleeding risk
  • Ergotamine or dihydroergotamine used for migraines: Clarithromycin must not be taken with them
  • Sildenafil, tadalafil or vardenafil: Clarithromycin can increase the levels of the erectile dysfunction (ED) medication in the body. Consider reducing the dose of the ED medication while taking Clarithromycin. 
Allergic reactions to medication

An itchy rash, swollen face or mouth, or difficulty in breathing, may be signs that you are allergic to the medication. 

Please note that i-GP DOES NOT TREAT Medical Emergencies. For Medical Emergencies please call 999.

If you develop a sudden onset of any of the symptoms below then you must STOP the medication immediately and seek urgent medical advice. This could be from your GP, Out of Hours Service, Urgent Care Centre or NHS 111. Call an ambulance using 999 or go to A&E if the symptoms are severe.

  • Wheeze
  • Difficulty in Breathing
  • Swelling of the eyelids, face or lips
  • A rash particularly if affecting your entire body
When to seek further medical advice

Please note that i-GP DOES NOT TREAT Medical Emergencies. For Medical Emergencies please call 999.

If you develop any of the following symptoms, then it is important to seek medical advice as soon as possible (from your GP, Out of Hours Service, Urgent care centre or call NHS 111):

  • If you develop a persistent high fever (high temperature) which can cause shivers.
  • If the pain becomes worse.
  • If you feel increasingly unwell (this may include nausea and vomiting).
  • If you develop spreading redness affecting your skin around the site of your infection.
  • If you develop any painful, red and hot joints near to the infection.
  • If you develop any flu-like symptoms.

If you develop any of the following symptoms, then you must seek urgent medical advice immediately (from your GP, Out of Hours Service, Urgent care centre, NHS 111). Call an ambulance using 999 or go to A&E if the symptoms are severe.

  • drowsiness or confusion
  • dizziness or feeling faint
  • difficulty in breathing, a wheeze or shortness of breath
  • a severe headache
  • if you are unable to look at bright lights (photophobia)
  • chest pain or a fast heart rate
  • persistent vomiting
  • neck stiffness
  • non-blanching rash
Antibiotic Guardianship

Antibiotics should be used responsibly and only when really necessary. Overuse and misuse of antibiotics can lead to antibiotic resistance. This is where the antibiotic becomes less effective at treating certain types of bacterial infection, so they do not work when needed. 

Antibiotics should be taken as prescribed, and it is important to complete the full course, this can reduce the chance of the bacteria developing an immunity to that antibiotic. It is important not to share antibiotics, and always take unused medication to your local pharmacy for disposal.

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