Antimicrobial stewardship & self-care advice

Antimicrobial treatment is appropriate for impetigo but patients/parents need to understand how to use the treatment correctly. 

Table 1 (next screen) shows how the CHESTSSS consultation structure, developed by the Royal College of General Practitioners, could be tailored to consultations about impetigo.

A discussion based on this framework also provides an opportunity to educate patients about appropriate and effective use of antibiotics and to reinforce good antimicrobial stewardship.

Self-care advice

Ensure that parents/guardians/patients get the best out of treatment by providing self-care advice:

• Gently remove crusts by washing with antibacterial soap/liquid skin wash before applying the hydrogen peroxide cream
• Avoid touching patches of impetigo as you may spread the infection to other areas
• Always wash your hands with soap after accidentally touching the area
• Wash your hands before and after putting the cream or ointment on the impetigo
• Do not share towels, flannels or other items until the infection has cleared. Always use a clean cloth on each occasion to dry the affected area
• The patient’s towels and bedlinen should be washed on the hottest available setting (at least 60⁰C) with the addition of laundry bleach
• Children with impetigo should be kept off school or nursery until the affected areas have healed or 48 hours after starting antibiotic treatment.