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Antibiotic creams or ointments

BMJ Group Medical Reference

Antibiotics are the first treatment you’re likely to be prescribed. Studies show antibiotic creams and ointments work well for many people. [4] [6]

You apply the cream or ointment to the affected areas of the skin. It usually contains an antibiotic called fusidic acid. The brand name is Fucidin. [7] You’ll probably use it for about seven days. You need a prescription from your doctor for these creams and ointments.

Some doctors say you should clean off the scabs with warm soapy water, or an antiseptic solution, before using antibiotic creams. But there’s no evidence to say whether this helps. [1] It can be difficult to do, especially with small children, and it can hurt.

One good-quality study showed that about 58 in every 100 people using antibiotic cream or ointment were likely to be cured of impetigo, compared with 21 in every 100 people using a dummy (placebo) cream. [6]

The study didn’t find that one type of antibiotic cream worked better than any other type. It said that having treatment with an antibiotic cream or ointment may work slightly better than taking some types of antibiotic tablets. [6]

However, some bacteria are resistant to fusidic acid. That means they’ve evolved so that this type of antibiotic no longer kills them. This is becoming more common. As many as 1 in 10 people with skin infections caused by Staphylococcus aureus worldwide may have an infection that can't be killed by fusidic acid. [5]

People with eczema are much more likely to have bacteria that are resistant to fusidic acid. If you’ve used fusidic acid before, you’re more likely to find it doesn’t work if you get impetigo again. The more you use fusidic acid, the more likely the bacteria affecting your skin are to become resistant to it. [5]

If you can't use fusidic acid (because you're allergic to it, or because your type of impetigo bacteria are resistant to it), you may be treated with another antibiotic cream, or with antibiotic tablets.

Some research shows that a new antibiotic ointment called retapamulin (brand name Altargo) may help against some types of resistant bacteria. [8] [9] But it doesn't work against all types, and doctors in Scotland have been advised not to use it. [10]

Antibiotic creams and ointments can irritate the skin, causing redness or itchiness. Some people are allergic to them, although that’s not common. [11]

Antibiotic creams and ointments seem less likely to cause side effects than antibiotic tablets. [6]

If your impetigo doesn’t go away after a week of fusidic acid treatment, your doctor will probably prescribe antibiotic tablets.

Glossary

eczema

Eczema is a very itchy rash. It may be dark and bumpy and release fluid. Scratching makes it worse. You can get eczema anywhere on your body, but it is most common on the wrists, the insides of the elbows and the backs of the knees. If you have asthma or allergies you are more likely to get eczema than someone who doesn't have these conditions.

placebo

A placebo is a 'pretend' or dummy treatment that contains no active substances. A placebo is often given to half the people taking part in medical research trials, for comparison with the 'real' treatment. It is made to look and taste identical to the drug treatment being tested, so that people in the studies do not know if they are getting the placebo or the 'real' treatment. Researchers often talk about the 'placebo effect'. This is where patients feel better after having a placebo treatment because they expect to feel better. Tests may indicate that they actually are better. In the same way, people can also get side effects after having a placebo treatment. Drug treatments can also have a 'placebo effect'. This is why, to get a true picture of how well a drug works, it is important to compare it against a placebo treatment.

For more terms related to Impetigo

Citations

For references related to Impetigo click here.
Last Updated: June 20, 2012
This information does not replace medical advice.  If you are concerned you might have a medical problem please ask your Boots pharmacy team in your local Boots store, or see your doctor.

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