Impetigo

In addition to the topical or oral antibiotic, twice-daily washing with soap and water or an antiseptic cleanser (e.g., chlorhexidine) might be effective in helping to clear the infection. This may also be recommended for close patient contacts who may have acquired the bacteria. Advise patients to return for re-assessment if: 1. the lesions are not healing following the course of antibiotic treatment (healing lesions will be dry); 2. the lesions continue to spread or become painful; or 3. they develop systemic symptoms, such as fever.

Instruct patients prescribed antibiotic cream or ointment to apply it to the infected sites; if intranasal treatment is prescribed, additionally instruct them to place medicine in each nostril for the treatment of nasal bacterial colonisation. To reduce the risk of transmission, contact with the patient should be avoided until lesions are crusted or healed, or 48 hours after starting antibiotic treatment.[40]UK Health Security Agency​. Children and young people settings: tools and resources. Oct 2023 [internet publication]. https://www.gov.uk/government/publications/health-protection-in-schools-and-other-childcare-facilities/children-and-young-people-settings-tools-and-resources