Treatment of Impetigo in the Pediatric Population: Consensus and Future Directions

Background: Impetigo is a common contagious superficial bacterial skin infection. Treatment of localized lesions can be achieved through topical antibiotics. Oral antibiotics are reserved for extensive disease. Increasing antimicrobial resistance to existing therapies have duce raised bacterial concerns. resistance. Antimicrobial This review stewardship, highlights treatment achieved Dothrough options Notfor the Copy impetigo responsible and use shares of antibiotics, consensus is statements an important to measure help guide to the re-management Objective: An of expert impetigo panel in of the dermatologists pediatric population. and pediatricians Penalties convened Apply in February 2019 to establish evidence-based consensus on the management of impetigo in the pediatric patient population. Methods: The consensus was created in accordance with the Appraisal of Guidelines, Research and Evaluation (AGREE) II instrument. Prior to the consensus meeting, a systematic literature review was conducted, with the selected literature deemed clinically relevant to the consensus statements. Statements were further refined and assessed systematically following established standards. The consensus process consisted of a modified Delphi approach. The consensus was established through a minimal 75% “agree” rate. Results: Thirteen consensus statements were developed addressing clinical challenges, existing treatment options and their limitations, and new therapeutic alternatives. Conclusion: Bacterial resistance to antimicrobials commonly used in treating impetigo has been reported. Antimicrobial stewardship is critical to optimize patient outcomes and to prevent the development of resistance. Healthcare providers should be aware of local resistance patterns in impetigo to help guide therapy. The use of newer safe and effective topical antibiotic alternatives as a first-line treatment should be an important step in antimicrobial stewardship.