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Comparison of mupirocin and erythromycin in the treatment of impetigo

1990; Elsevier BV; Volume: 117; Issue: 5 Linguagem: Inglês

10.1016/s0022-3476(05)83352-9

1097-6833

L.T. Jeffrey, Wright Britton, J. Eduardo Fajardo, Brian Krafte‐Jacobs,

Clostridium difficile and Clostridium perfringens research

For the past two decades the accepted treatment of impetigo has been systemic antibiotic therapy, l The recently approved topical antibiotic mupirocin has excellent in vitro activity against Streptococcus pyogenes and Staphylococcus aureus, including multiply resistant strains. Originally called pseudomonic acid A, mupirocin is obtained from submerged fermentation of Pseudomonas fluorescens; it acts by inhibition of bacterial protein synthesis by inactivation of isoleucyl transfer RNA synthetase. Rapidly inactivated and rapidly excreted when given systemically, mupirocin has been shown to be safe in animal and human trials.2, 3 Double-blind studies prove mupirocin to be more effective than its polyethylene glycol vehicle for treatment of impetigo.4, 5 Several nonblind or poorly controlled clinical trials have suggested that mupirocin's efficacy is comparable to that of orally administered antibiotics commonly used to treat impetigo, namely, erythromycin, 6-1~ ampicillin, 11 and dicloxacillin. 12 We intended to validate these findings in a double-blind, placebo-controlled study. We further hypothesized that erythromycin would cause more adverse side effects and result in poorer compliance, making mupirocin the preferred medication.