Impetigo in children

Question 1

What are the two types of impetigo?

Answer 1

1. Non-bullous impetigo
2. Bullous impetigo (> 1cm)

Question 2

What are the causative organism for the two types of impetigo?

Answer 2

Non-bullous impetigo: Staph aureus, Strep. pneumoniae

Bullous impetigo > 1cm: Staph. aureus

Question 3

Management for the two types of impetigo

Answer 3

• Non-bullous/localised impetigo: Topical Abx Fusidic acid TDS 3/7
• Bullous impetigo > 1cm /widespread impetigo: Oral Abx Flucloxacillin QDS 7/7
• Refer urgently if signs of sepsis

Question 4

What is the school exclusion rule for impetigo for children?

Answer 4

Excluded from school, nursery, or childcare settings until:

All lesions are healed, dry, and crusted over

OR

48 hours after starting appropriate treatment