Abstract：
Context Impetigo affects millions of children worldwide. Most guidelines recommend antibiotics as first-line treatment however topical antiseptics present a potentially valuable, understudied, antibiotic-sparing treatment for mild impetigo. Objective We aimed to determine the feasibility of a randomized controlled trial (RCT) comparing efficacy of soft white paraffin (SWP), hydrogen peroxide (H2O2) and mupirocin for mild impetigo. Study Design The study was designed in keeping with the SPIRIT statement and designed in accordance with the CONSORT statement for pilot RCTs Setting, population studied Consecutive patients presenting with mild impetigo were recruited from two private general practices in North Queensland, Australia. Intervention: Participants were randomly assigned to one of three treatments: soft white paraffin (SWP), hydrogen peroxide (H2O2) and mupirocin ointment. Outcome measures: Size and number of lesions were measured at the initial consultation and day six. Post-recruitment, interviews with General Practitioners were transcribed and themes identified to determine protocol acceptability, recruitment barriers and avenues to improve delivery. Results Two participants received SWP (n=1) and mupirocin (n=1). Both commenced oral antibiotics following failure of topical treatment. Recruitment barriers included reduced presentation of impetigo due to COVID-19, pre-treatment with existing at-home medications and moderate/severe infection. Childcare centers and pharmacies were identified as alternative venues to improve recruitment rate. Conclusions Valuable insight was gained into the practicality of conducting a RCT of impetigo treatments in general practice. Future trials should consider recruiting outside of general practice clinics to capture patients at earlier, more mild stages of infection. Further investigation into the prevalence and impact of use of at-home expired antibiotics may be beneficial.
摘要：
背景Impetigo影响全球数百万儿童。大多数指南推荐抗生素作为一线治疗，但是局部防腐剂具有潜在的价值，研究不足,轻度脓疱疮的抗生素保留治疗。目的探讨比较软白石蜡(SWP)疗效的随机对照试验(RCT)的可行性,过氧化氢（H2O2）和莫匹罗星治疗轻度脓疱病。研究设计该研究的设计符合SPIRIT声明，并根据试点RCT设置的CONSORT声明进行设计。研究人群从北昆士兰州的两个私人一般诊所招募了连续出现轻度脓疱病的患者，澳大利亚。干预：参与者被随机分配到三种治疗方法之一：软白石蜡（SWP），过氧化氢（H2O2）和莫匹罗星软膏。结果测量：在初次咨询和第六天测量病变的大小和数量。招聘后，对全科医生的访谈进行转录，并确定主题以确定协议的可接受性，招聘障碍和改善交付的途径。结果两名参与者接受SWP（n=1）和莫匹罗星（n=1）。两者都在局部治疗失败后开始口服抗生素。招募障碍包括由于COVID-19导致脓疱病的出现减少，使用现有的家庭药物进行预处理以及中度/重度感染。托儿所和药房被确定为提高招募率的替代场所。结论在一般实践中对脓疱疮治疗进行RCT的实用性获得了宝贵的见解。未来的试验应该考虑在全科诊所之外招募更早的患者，更温和的感染阶段。进一步调查在家使用过期抗生素的患病率和影响可能是有益的。
