Medicine for Impetigo: Antibiotics, Cream, Ointment and OTC Drugs

Impetigo is a bacterial skin condition that mostly occurs in children. They are two types, bullous and nonbullous impetigo. Their main difference is that the former results in larger blisters which are more likely to cause scarring.

The infection presents with vesicles or pustules which quickly break open and crust over to form honey-colored scabs. See impetigo early stage pictures for illustrations. Even without treatment, the blisters often heal without scarring. Scratching increases the risk of getting scars where impetigo blisters have healed.

Bacterial infections are primarily treated with antibiotics. The same applies to impetigo. Patients are advised to seek medical attention since OTC drugs aren’t always effective in completely getting rid of harmful bacteria. No single general treatment therapy is agreed upon. Doctors use a wide variety of medications as well as disinfecting agents for treatment. This article examines common impetigo medicine, including their side effects.

List of topical antibiotics for impetigo


Mupirocin is applied directly on affected skin. It works by inhibiting a certain enzyme required in the synthesis of proteins essential for bacterial growth. The drug has been in conventional use since the late 1980s.

Patients are required to have a prescription to access mupirocin. It is available in the brand names Bactroban and Centany. It also is available as a generic drug.

Side effects of mupirocin include:

  • Stinging
  • Burning
  • Itchiness
  • Pain

When used for treatment of impetigo in nasal passages, side effects such as headaches, sore throat, runny nose and irritation may occur.

Altabax (Retapamulin):

Retapamulin is an FDA approved topical antibiotic for impetigo. It can be used even in children over 9 months old. The drug works by inhibiting the process by which proteins are synthesized in bacteria. To avoid bacterial resistance, it is very important that Retapamulin be only used when diagnosis has confirmed that infection is indeed bacterial.

Retapamulin side effects may include:

  • Burning
  • Swelling
  • Redness
  • Itching
  • Irritation
  • Nausea

Ozenoxacin (Xepi):

Ozenoxacin is another FDA approved topical antibiotic for impetigo. It can be used in patients as young as 2 months old. The drug has been found to be effective on MRSA. It should be used twice a day for five days.

Ozenoxacin comes in form of pale yellow cream 1% in strength. A thin layer of the cream is to be applied directly to affected areas.

Sometimes, several antibiotics are combined into a single cream or ointment. A good example is bacitracin for impetigo which may come in combined form with polymixin B and neomycin.

Advantages and disadvantages of topical antibiotics for impetigo

Once diagnosed with impetigo, a patient can choose between oral and topical antibiotics. Below are the reasons why topical medications may be a better choice:

  • Easy to apply – in a complete impetigo definition, you will learn that it is an infection of the superficial layer of the skin. Topical medications only require directly administration. This can prove particularly advantageous especially when dealing with impetigo in children. After application, a loose bandage or dressing can be used to keep the medication in place.
  • Reduced risk of severe side effects – topical medications do not interact with internal body systems such as circulation and digestion. It is therefore unlikely that side effects such as nausea and vomiting will occur.
  • More active ingredient – oral medications are sometimes not absorbed fully especially after a heavy or fatty meal. This means that patients may not get full dosage measurement as recommended. In the end, complications such as bacterial resistance may occur.
  • More affordable – impetigo treatment cream or ointment is generally more affordable in terms of cost compared to oral impetigo medicine.

Like everything with advantages, topical medications have their disadvantages. These include:

  • Bacterial resistance – although bacterial resistance is also observed with oral medications, it is more likely and common with topical medications.
  • Disruption of cutaneous flora – not all bacteria are harmful. In fact, a majority of bacteria found on the skin are beneficial. Topical antibiotics do not have a mechanism to differentiate between good and bad bacteria. As a result, even good bacteria are destroyed once topical medications are applied.
  • Possibility of allergic reactions – a common side effect of topical antibiotics is skin irritation. Irritation is on the other hand a common trigger of a skin condition known as atopic eczema.

In most cases, topical medications are considered as first lines of defense against impetigo. This is partly because impetigo is usually not a serious infection. Your doctor is always best suited to prescribe the ideal medication.

List of oral antibiotics for impetigo


Amoxicillin for impetigo is used with clavulanate. The two work by controlling bacterial growth. A doctor should instruct these drugs are to be taken. This is because the ratios in which the two are mixed may differ depending on the drug measurement.


Clindamycin is a common antibiotic. It is reserved for serious cases such impetigo ear infection. Common dosage measurement is 300 to 600 mg to be taken every 6 to 8 hours.

Cephalexin (Keflex):

Cephalexin belongs in the class of first-generation cephalosporins. It is commonly used to treat bacterial infections including cellulitis and impetigo. The drug works by stopping growth of bacterial cell wall. Cephalexin also works on bacteria resistant to erythromycin.

In adults, the common dosage is 500mg to be taken after every 6-8 hours for 10 days. This dosage measurement differs in children.

Most patients find cephalexin tolerable. Inform your doctor if you are allergic to penicillin.


Dicloxacillin is another commonly used antibiotic for treatment of different bacterial infections. It is available with prescription. Patients who are allergic to penicillin should not use Dicloxacillin. Common dosage measurement is 250mg to be taken every 6 hours. Side effects may include throat irritation, less urine, nausea and headaches.

Advantages and disadvantages of oral impetigo medicine


  • Oral medications are more effective on serious infections.
  • They are better suited to treat impetigo caused by MRSA and other strains of resistant bacteria.
  • Their application is not as laborious as of topical medications.
  • They do not interfere with cutaneous flora.


  • More likely to cause more severe side effects such as nausea and vomiting. This is due to potential alteration of intestinal flora.
  • Require higher dosages for maximum effects.
  • Generally more expensive.

Oral antibiotics to cure impetigo are usually reserved for serious infections. Always check with your doctor before using oral medications. One of bacterial resistance causes is unnecessary or incomplete use of antibiotics.

Impetigo pregnancy interaction may be observed when taking oral medications. Pregnant women should talk with their doctor before starting treatment.

Impetigo treatment over the counter

There are different brands of creams, ointments and products available for impetigo treatment over the counter. However, no professional will advise you to go for any of these. Impetigo is caused by staphylococcus and streptococcus bacteria. These bacteria are common but unfortunately not easy to treat without the appropriate antibiotics.

Buying an ointment for impetigo over the counter can for example result in bacterial resistance or infection recurrence. Every time we use antibiotics, we give bacteria a chance to develop mechanisms with which to resist treatment with antibiotics.

When patients finish their medications, all bacteria are destroyed. This means that resistance genes will not be passed to a next generation. Over the counter medications do not always come with specific instructions on how to use.

Diagnosis is an important part of treatment. It ensures that medications are given for the right purpose. Since over the counter medications can be taken without diagnosis, patients may end up taking antibiotics unnecessarily. This is another issue that leads to bacterial resistance.

The bottom line is that over the counter treatment for impetigo is not recommended. In any case, conventional treatment usually takes less than 10 days. The same bacteria that cause impetigo in humans cause the infection in animals. This means that even in cases such as dog or puppy impetigo infection, a vet should be approached.

A much similar case is encountered when dealing with herpes. Herpes is a viral disease and therefore has no cure. Available treatment options seek to manage its symptoms as well as to promote faster recovery. Without treatment, herpes sores can last up to 2 weeks. This period significantly drops with medications. See impetigo vs herpes treatments for comparison.

How to treat impetigo at home

Impetigo is highly contagious and quite common. It is the most diagnosed skin infection in children. Fortunately, many cases can be improved or treated with home treatments and remedies. Here is how to treat impetigo at home:

Use home remedies.

Home remedies such as tea tree oil and apple cider vinegar are popularly known for their antimicrobial properties. They may help control growth of the bacteria responsible for impetigo. Essential oils can also prove helpful especially if impetigo is resulting from conditions such as eczema caused by skin dryness. It is always important to get exact details on how a certain home remedy should be used before application. Home remedies are considerable choices when treating impetigo on back or on legs.

Control transmission.

The bacteria that cause impetigo often launch invasions once inside the skin. It is possible but rare for impetigo to begin on intact skin. Transmission can be controlled by covering affected areas, keeping wounds clean and using treatment medications. See how long is impetigo contagious for more details.

Know the risk factors.

People get impetigo mainly after direct skin to skin contact with an infected person. Healthy adults can carry causative bacteria without signs of illness. This may result in infection in infants. Not everyone who comes into contact with impetigo bacteria gets infected. Certain factors such as weakened immunity, age, congested places and skin injuries increase the risk of getting infected. Fortunately, most of these risk factors can be improved with impetigo natural treatment.

Learn how to prevent impetigo.

A number of practices and measures are available for impetigo prevention. For example, keeping nails short ensures that bacteria are not picked from the site of infection to elsewhere in the body. Washing bed linen and clothes helps prevent spread of infection from one household member to another. Keeping infected kids out of school keeps infection from being passed to others.