UNASSIGNED: Randomized clinical trials that evaluated the use of topical antibiotics for treatment of impetigo were included. Two thousand eighty-nine studies were initially identified, and five randomized clinical trials met the criteria for further analysis.
UNASSIGNED: Topical antibiotics had greater resolution of impetigo in comparison to vehicle in these pivotal clinical trials. Adverse events were minimal, with the most common being pruritus at the application site. Cost or insurance coverage may be a limiting factor in choosing the best therapeutic agent, with mupirocin ointment having the lowest cost. Mupirocin has shown clinical efficacy against MRSA but a bacterial culture is recommended to rule out resistance. Ozenoxacin and retapamulin are effective alternatives but may entail higher cost. Retapamulin is indicated for lesions of impetigo that are colonized by MSSA and streptococcus S. pyogenes but not MRSA based on clinical efficacy of phase III trials. Fusidic acid, available in other countries, is a non-FDA approved medication although rising resistance rates represent a growing concern.
■包括评估局部抗生素治疗脓疱病的随机临床试验。最初确定了两千八十九项研究,5项随机临床试验符合进一步分析的标准.
■在这些关键的临床试验中,与载体相比,外用抗生素对脓疱病的分辨率更高。不良事件很少,最常见的是申请部位瘙痒。成本或保险范围可能是选择最佳治疗剂的限制因素,莫匹罗星软膏的成本最低。莫匹罗星已显示出对MRSA的临床疗效,但建议进行细菌培养以排除耐药性。奥替诺沙星和retapamulin是有效的替代品,但可能需要更高的成本。根据III期试验的临床疗效,瑞帕莫林适用于由MSSA和化脓性链球菌而不是MRSA定植的脓疱病病变。夫西地酸,在其他国家可用,是一种非FDA批准的药物,尽管不断上升的耐药率代表了一个日益增长的担忧。