Editor—Koning and van der Wouden write that guidelines may contain policies to reserve certain antibiotics for the treatment of other, more serious infections.1 For example, systemic fusidic acid is considered to be crucial in treating severe bone infections, and mupirocin is a cornerstone in eradicating the carriage of methicillin resistant Staphylococcus aureus (MRSA).
The Swedish Medical Products Agency would probably agree. It recommended that Swedish doctors and nurses should use neither fusidic acid nor mupirocin topically. Fusidic acid resistant S aureus has rapidly spread in Sweden, and we in Sweden are anxious to save mupirocin to help us maintain our favourable MRSA situation. Impetigo should be treated with soap and water, or with oral antibiotics, according to the Swedish Medical Products Agency.
Competing interests: None declared.
References
- 1.Koning S, van der Wouden JC. Treatment for impetigo. BMJ 2004;329: 695-6. (25 September.) [DOI] [PMC free article] [PubMed] [Google Scholar]