Impetigo Treatment and Antimicrobial Resistance

A recent review in the Journal of Drugs in Dermatology examined information provided to clinicians and stakeholders regarding antimicrobial resistance (AMR) in the treatment of impetigo. 

Impetigo is a contagious bacterial infection that affects the superficial skin layers and the topical agents prescribed for the condition are seeing increased worldwide AMR, causing treatment failure. In response, the Worldwide Health Organization (WHO) developed a global action plan on AMR but omitted AMR stewardship program information for topical antibiotics.

The review used literature searches—clinical trials, research studies, clinical guidelines, consensus papers, and reviews (if they provided original data)—published between January 2008 and May 2019 to examine the status of AMR to current topical antibiotics in impetigo, current therapeutic behavior, and concordance with antimicrobial stewardship principles, according to the authors.

The articles were selected by impetigo management relevancy, clinical efficacy, treatment safety, and antimicrobial resistance. Of the 198 articles found, 19 met the inclusion criteria and were considered by 2 international panels who convened to discuss the search output. The panel discussions were then used in the development of the manuscript. 

The authors concluded that while published antimicrobial stewardship guidelines have focused on systemic antibiotics, very few have evaluated the topical antibiotic prescribing practices for impetigo treatment.

“The appropriate use of topical ozenoxacin (Xepi; Biofrontera Inc) can help eradicate impetigo while minimizing AMR,” they wrote.

Reference:

Schachner LA, Lynde CW, Kircik LH, et al. Treatment of impetigo and antimicrobial resistance. J Drugs Dermatol. 2021;20(4):366-372. doi: 10.36849/JDD.2021.5795.