GPs should not prescribe antibiotics for impetigo, says NICE

GPs should prescribe hydrogen peroxide 1% cream rather than topical antibiotics for patients with non-bullous impetigo, according to new NICE guidance.

(Photo: Peter Zownir/Getty Images)
(Photo: Peter Zownir/Getty Images)

Final guidance on impetigo published by NICE and Public Health England says that hydrogen peroxide 1% cream is just as effective as a topical antibiotic in patients with localised, non-bullous impetigo, providing they are not systemically unwell or at risk of developing any complications.

According to the guidelines, if hydrogen peroxide 1% cream is unsuitable then GPs should offer a short course of a topical antibiotic. NICE found no evidence to support the use of any other topical antiseptics to treat the condition.

If symptoms have not improved, or worsened, following treatment with a topcial antiseptic, patients should be prescribed a topical antibiotic if the condition is still localised. GPs could consider an oral antibiotic if the impetigo has become more widespread, the guidance says.

Patients with widespread non-bullous impetigo who are not systemically unwell should be prescribed a topical or oral antibiotic, according to the guidance.

Oral antibiotics should be prescribed to patients with bullous impetigo, or if they are systemically unwell or at high risk of complications.

Antiobiotic prescribing

Patients should not be offered combination treatment with a topical and oral antibiotic. NICE said there was no evidence to suggest that prescribing both was more effective than a topical treatment alone.

The guidance says that first-line topical antiobiotic treatment should be fusidic acid 2%, with the second choice mupirocin 2%. First-line oral antibiotics should be flucloxacillin, with clarithromycin as a second choice, or erythromycin in women who are pregnant.

The guidance is part of a series of advice on antimicrobial prescribing for managing common infections from NICE, which has been developed with Public Health England. NICE had consulted on a draft version of this latest guidance last year.

Have you registered with us yet?

Register now to enjoy more articles and free email bulletins

Register

Already registered?

Sign in

Follow Us:

Just published

Under 40s to be offered alternative to AstraZeneca COVID-19 vaccine

Under 40s to be offered alternative to AstraZeneca COVID-19 vaccine

Patients aged 30-39 will be offered an alternative to the Oxford/AstraZeneca COVID-19...

GPs per patient down 10% in just five years, NHS data reveal

GPs per patient down 10% in just five years, NHS data reveal

The number of fully-qualified, full-time equivalent (FTE) GPs per patient in England...

Supportive model must replace harmful CQC inspections, BMA chair warns

Supportive model must replace harmful CQC inspections, BMA chair warns

CQC inspections that ‘divert time away from patient care’ and ‘instil fear’ among...

UK COVID-19 vaccination programme tracker

UK COVID-19 vaccination programme tracker

GPs across the UK are playing a leading role in the largest-ever NHS vaccination...

A 'tsunami' of work is drowning general practice: GPs speak out about a profession at its limit

A 'tsunami' of work is drowning general practice: GPs speak out about a profession at its limit

Rocketing workloads created by huge backlogs of cases and continuing COVID-19 disruption...

Slight increase in GP workforce during past year, but number of partners continues to fall

Slight increase in GP workforce during past year, but number of partners continues to fall

The GP workforce grew by 0.4% in the year to March 2021, but the number of GP partners...