Treatment of impetigo: Save mupirocin

doi:10.1136/bmj.329.7472.979-a

BMJ 2004;329:979 (23 October), doi:10.1136/bmj.329.7472.979-a

Letter

Treatment of impetigo

Save mupirocin

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Editor—Koning and van der Wouden write that guidelinesmay contain policies to reserve certain antibiotics for thetreatment of other, more serious infections.¹ For example, systemicfusidic acid is considered to be crucial in treating severebone infections, and mupirocin is a cornerstone in eradicatingthe carriage of methicillin resistant Staphylococcus aureus(MRSA).

The Swedish Medical Products Agency would probably agree. Itrecommended that Swedish doctors and nurses should use neitherfusidic acid nor mupirocin topically. Fusidic acid resistantS aureus has rapidly spread in Sweden, and we in Sweden areanxious to save mupirocin to help us maintain our favourableMRSA situation. Impetigo should be treated with soap and water,or with oral antibiotics, according to the Swedish Medical ProductsAgency.

Inge Axelsson, associate professor

Department of Health Sciences, Mid-Sweden University, SE-831 25 Ostersund, Sweden inge.axelsson@mh.se

Competing interests: None declared.