Impetigo
Typically, impetigo
and skin infections are caused by Staphylococcus aureus and only rarely by
Streptococcus pyogenes. Staphylococcus aureus in the
produces b lactamase, rendering amoxicillin useless.
Clinicians would be wiser to initiate
treatment with a b lactamase-stable antibiotic, such as
amoxicillin-clavulanate, cefdinir or even cefuroxime,
which possess activity against both
methicillin-susceptible Staphylococcus aureus and typical otopathogens.
Patients whose skin infection does
not respond in 24–28 h would then
additionally receive either clindamycin
or trimethoprim-sulfamethoxale
for presumptive methicillin-resistant
Staphylococcus aureus.
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