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Impetigo - Management
What should I do if initial treatment is not fully effective?
- If lesions are not improving 7 days after initiation of treatment or the condition is worsening:
- Review the diagnosis and any underlying cause.
- Check compliance with treatment and hygiene measures.
- Take a swab.
- If topical fusidic acid was used, assess whether the impetigo has spread.
- If it has, consider prescribing an oral antibiotic.
- If it has not, consider a trial of topical retapamulin (for 5 days; do not use topical antibiotics for longer than 2 weeks).
- If an oral antibiotic was used, consider extending treatment for an additional week while waiting for swab results.
- For people with recurrent impetigo, consider taking nasal swabs to detect staphylococcal carriage, and additionally consider swabbing the immediate family.
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