Published: 2019-07-24

A randomised open label comparative study evaluating the effectiveness, adherence and safety between 2% mupirocin ointment and 2% fusidic acid cream in children with impetigo

Ravichandran Velappan, Sindhuja Ramasamy, Shridhar Venu, Muthusubramanian Chandrasekar


Background: Impetigo is a superficial bacterial skin infection that affects mainly children, which is highly contagious. Topical anti-bacterials are most commonly used in both primary and secondary impetigo. Clinical trials have shown high efficacy of these topicals along with systemic antibiotics in both complicated and uncomplicated impetigo. However use of these topical modalities alone in uncomplicated primary impetigo is limited. The aim of the study was to compare the efficacy, safety and adherence to treatment of mupirocin with fusidic acid in primary impetigo.

Methods: A total of 60 patients with a clinical diagnosis of primary impetigo, between 2-14 years of age, having <10 lesions, skin infection rating score >4 and pus score equal to or more than one who attended Dermatology OPD, in Chengalpattu Medical College Hospital from February 2018 to March 2019. Study design was a comparative analytical study.

Results: Baseline disease characteristics such as number of lesions, the severity of disease (SIRS), and pus scores were statistically similar between the two groups. The clinical improvement observed with mupirocin (25/30) and fusidic acid (24/30) treatment in primary impetigo was not statistically significant (p>0.05). Both drugs were tolerated well.

Conclusions: Both mupirocin and fusidic acid showed similar clinical success in patients with primary impetigo. Though fusidic acid has additional anti-inflammatory property and its treatment is cost effective, but irritant effects observed in some patients, which reduces the compliance, lead to consider mupirocin as first line treatment in primary impetigo. 


Primary impetigo, Skin infection rating scale, Clinical failure, Anti inflammatory, Adherence

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