What is the first-line treatment for non-bullous impetigo?

What is the first-line treatment for non-bullous impetigo?

• A. Cephalexin
• B. Mupirocin
• C. Amoxicillin-clavulanate
• D. Dicloxacillin

Answer: (A)

Non-bullous impetigo is typically treated based on how extensive the infection is. For truly mild, localized disease, a topical antibiotic such as mupirocin is preferred. When there are multiple lesions, the infection is more widespread, or topical therapy isn’t practical, starting an oral antibiotic becomes appropriate. Cephalexin is a common first-line oral choice because it covers the usual culprits—Streptococcus pyogenes and Staphylococcus aureus (including many penicillin-susceptible strains), has good skin penetration, and is well tolerated with straightforward dosing for both children and adults. This makes it a practical outpatient option when systemic therapy is indicated. Amoxicillin-clavulanate would be broader than needed for uncomplicated cases, and dicloxacillin is another option but cephalexin is often chosen for its dosing convenience and spectrum.

Non-bullous impetigo is typically treated based on how extensive the infection is. For truly mild, localized disease, a topical antibiotic such as mupirocin is preferred. When there are multiple lesions, the infection is more widespread, or topical therapy isn’t practical, starting an oral antibiotic becomes appropriate. Cephalexin is a common first-line oral choice because it covers the usual culprits—Streptococcus pyogenes and Staphylococcus aureus (including many penicillin-susceptible strains), has good skin penetration, and is well tolerated with straightforward dosing for both children and adults. This makes it a practical outpatient option when systemic therapy is indicated. Amoxicillin-clavulanate would be broader than needed for uncomplicated cases, and dicloxacillin is another option but cephalexin is often chosen for its dosing convenience and spectrum.