Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Clinical Trial
. 2002 Jan 26;324(7331):203-6.
doi: 10.1136/bmj.324.7331.203.

Fusidic acid cream in the treatment of impetigo in general practice: double blind randomised placebo controlled trial

Sander Koning  1 , Lisette W A van Suijlekom-Smit, Jan L Nouwen, Cees M Verduin, Roos M D Bernsen, Arnold P Oranje, Siep Thomas, Johannes C van der Wouden
Affiliations
Clinical Trial

Fusidic acid cream in the treatment of impetigo in general practice: double blind randomised placebo controlled trial

Sander Koning et al. BMJ. .

Abstract

Objective: To test the hypothesis that fusidic acid would not increase the treatment effect of disinfecting with povidone-iodine alone in children with impetigo.

Design: Randomised placebo controlled trial.

Setting: General practices in Greater Rotterdam.

Participants: 184 children aged 0-12 years with impetigo.

Main outcome measures: Clinical cure and bacterial cure after one week.

Results: After one week of treatment 55% of the patients in the fusidic acid group were clinically cured compared with 13% in the placebo group (odds ratio 12.6, 95% confidence interval 5.0 to 31.5, number needed to treat 2.3). After two weeks and four weeks the differences in cure rates between the two groups had become smaller. More children in the placebo group were non-compliant (12 v 5) and received extra antibiotic treatment (11 v 3), and more children in the placebo group reported adverse effects (19 v 7). Staphylococcus aureus was found in 96% of the positive cultures; no strains were resistant to fusidic acid.

Conclusions: Fusidic acid is much more effective than placebo (when both are given in combination with povidone-iodine shampoo) in the treatment of impetigo. Because of the low rate of cure and high rate of adverse events in the placebo group, the value of povidone-iodine in impetigo can be questioned.

PubMed Disclaimer

Figures

Figure
Figure
Flow and follow up of participants
See this image and copyright information in PMC

Comment in

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Dagan R, Bar-David Y. Double-blind study comparing erythromycin and mupirocin for treatment of impetigo in children: implications of a high prevalence of erythromycin-resistant Staphylococcus aureus strains. Antimicrob Agents Chemother. 1992;36:287–290. - PMC - PubMed
    1. Bruijnzeels MA, van Suijlekom-Smit LWA, van der Velden J, van der Wouden JC. The child in general practice. Rotterdam/Utrecht: Erasmus Universiteit/NIVEL; 1993.
    1. Boukes FS, van der Burgh JJ, Nijman FC, Sampers GM, Simon B, Romeijnders AC, et al. NHG-Standaard bacteriële huidinfecties [Dutch College of General Practitioners’ guideline on bacterial skin infections] Huisarts Wet. 1999;41:427–437.
    1. Resnick DS. Staphylococcal and streptococcal skin infections: pyodermas and toxin-mediated syndromes. In: Harper J, Oranje A, Prose N, editors. Textbook of pediatric dermatology. 1st ed. Oxford: Blackwell; 2000. pp. 369–372.
    1. Hay RJ, Adriaans BM. Bacterial infections. In: Champion RH, Burton JL, Ebling FJG, editors. Rook/Wilkinson/Ebling, Textbook of dermatology. 6th ed. Oxford: Blackwell; 1998. pp. 1109–1111.

Publication types

MeSH terms