Key points

• The natural history of impetigo is not known.

• Few placebo-controlled studies have been done.

• Many different antibiotic treatments have been studied against each other, often in small studies showing no significant differences.

• There is no evidence supporting the value of disinfecting treatments.

• Macrolide and cephalosporine antibiotics are more effective than non-betalactamase-resistant pencillins.

• Topical antibiotics such as mupirocin and fusidic acid are equally effective as oral antibiotics such as erythromycin and have fewer side-effects.

• Resistance patterns in causative bacteria change over time and should be taken into account when choosing a therapy for impetigo.

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