Impetigo Drug Spectrum and Facts

staphylococcus aureus
most common bug to cause of impetigo?

Penicillinase-resistant penicillins (dicloxacillin)
or might try
1st gen cephalosporins (cephalexin)
preferred treatment for impetigo caused by Staph aureus ?

Single IM dose of benzathine, penicillin G, or oral penicillin VK
Treatment for infections caused by S. pyogenes ?

7-10 days, can use 7 day course of topical mupirocin (Bactroban) or retapamulin (Altabax) for mild cases.
Duration of impetigo therapy?

Lotrimin/Lotrimin AF
Clotrimazole or MIconazole Nitrate

Lotrimin Ultra
Butenafine HCl


Betadine First Aid Antibiotics + Moisturizer Ointment
Polymyxin B sulfate 10,000 U/g; bacitracin zinc 500 U/g

Q-tips Treat & Go x
Cotton swabs containing bacitracin 500 U/g

Gold Bond First Aid Antibiotic Ointment
Bacitracin zinc 500 U/g; polymyxin B sulfate 10,000 U/g; neomycin base 3.5 mg/g; pramoxine HCL 10 mg

Neosporin Ointment
Polymyxin B sulfate 5000 U/g; bacitracin zinc 400 U/g; neomycin base 3.5 mg/g

Neosporin Plus Pain Relief Ointment
Bacitracin zinc 500 U/g; polymyxin B sulfate 10,000 U/g; neomycin base 3.5 mg/g; pramoxine HCL 10 mg

Neosporin Plus Pain Relief Cream
Polymyxin B sulfate 10,000 U/g; neomycin base 3.5 mg/g; pramoxine HCl 10 mg

Polysporin Ointment/Powder
Polymyxin B sulfate 10,000 U/g; bacitracin zinc 500 U/g

Bacitracin + Polymyxin B + Neomycin + Hydrocortisone

Do any otc products cover MRSA?

Bactericidal (inhibits cell wall synthesis) G + and some G –
Bacitracin spectrum?

Bactericidal (aminoglycoside axb that irreversibly binds to 30S subunit to inhibit protein synthesis) G- bacilli and some G +. NOTE (topical has high rate of hypersensitivity reactions)
Neomycin (Neo-Fradin) Spectrum?

Bactericidal (increases cell membrane permeability) almost all strains of G- bacilli except proteus group. NOT effective against G+, fungi, or G- cocci. Only comes as a injection powder for solution
Polymyxin B Spectrum?

topical anesthetic that works by decreasing the neuronal membrane’s permeability to sodium ions
what is pramoxine?

Neosporin Plus Pain Relief Cream
Which otc topical agent does not contain Bacitracin zinc?

the skin is broken because of ointments impermeability.
Don’t use ointments if….

burns and wounds in which the skin is intact
When to use ointments?

Broken skin since they allow some fluid to pass through the film.
Creams are best for what?

Large wound or burn area because it is easy to apply.
Lotions useful for?

wound bed, because they can dry the area, difficult to remove, provide a medium for bacterial growth.
Lotions should not be used on a….

Neomycin, can causes sensitization reaction, contact dermatitis.
Avoid neosporin or polysporin in children?

Treats nasal carriers of MRSA Rx only. b.

Novel MOA of mupirocin: inhibits bacterial protein and RNA synthesis by reversibly and specifically binding to bacterial isoleucyl transfer-RNA synthetase; does not demonstrate cross-resistance with other classes. Bacteriostatic at low concentrations and bactericidal at high concentrations

Mupirocin is used to treat what? and what is the unique MOA?

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