Which antibiotic is considered first-line therapy for non-bullous impetigo?

Which antibiotic is considered first-line therapy for non-bullous impetigo?

• A. Cephalexin
• B. Amoxicillin
• C. Erythromycin
• D. Ciprofloxacin

Answer: (A)

Impetigo that isn’t bullous is commonly caused by Streptococcus pyogenes and Staphylococcus aureus. When systemic antibiotic therapy is needed, you want an agent that reliably covers both organisms, penetrates skin well, is well tolerated in children, and has a favorable safety profile. Cephalexin fits this well as a first-generation cephalosporin with good activity against streptococci and MSSA (though it doesn’t cover MRSA). It provides effective skin tissue levels and is a practical, well-tolerated option for pediatric impetigo. Amoxicillin covers streptococci but has less reliable Staphylococcus aureus activity, especially against beta-lactamase–producing strains. Erythromycin has increasing resistance among community pathogens. Ciprofloxacin is not preferred for non-bullous impetigo in children due to safety concerns and it’s not a first-line choice for this skin infection.

Impetigo that isn’t bullous is commonly caused by Streptococcus pyogenes and Staphylococcus aureus. When systemic antibiotic therapy is needed, you want an agent that reliably covers both organisms, penetrates skin well, is well tolerated in children, and has a favorable safety profile. Cephalexin fits this well as a first-generation cephalosporin with good activity against streptococci and MSSA (though it doesn’t cover MRSA). It provides effective skin tissue levels and is a practical, well-tolerated option for pediatric impetigo.

Amoxicillin covers streptococci but has less reliable Staphylococcus aureus activity, especially against beta-lactamase–producing strains. Erythromycin has increasing resistance among community pathogens. Ciprofloxacin is not preferred for non-bullous impetigo in children due to safety concerns and it’s not a first-line choice for this skin infection.