II. Medications
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Bacitracin Zinc
- Indicated for use on minor open wounds, Burn Injury and Skin Abrasions
- May speed Wound Healing (retains moisture within the wound, preventing eschar)
- When Antibiotics are not indicated, consider bland topicals (e.g. aquaphor) instead
- Apply one to three times daily
- Risk of Contact Dermatitis
-
Bacitracin Zinc is preferred over "triple Antibiotic" (Neomycin/polymyxin B/Bacitracin)
- Triple Antibiotic ointment has a greater risk of Contact Dermatitis, without significant added benefit
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Mupirocin (Bactroban) 2% ointment
- Impetigo: Applied three times daily to affected area for 7-10 days
- May be used in age 2 months and older
- Available as 22 g tube (ointment is less expensive than creams)
- Emerging Streptococcal resistance in 2014
-
Retapamulin (Altabax) 1% ointment
- Impetigo: Apply twice daily to affected area for 5 days
- May be used in age 9 months and older
- Treatment area must be <100 cm2 (or <2% total BSA in children)
- Fusidic Acid 2% cream (Not available in United States)
- Impetigo: Apply three times daily to affected area for 10-12 days
- Koning (2002) BMJ 324:203-6 [PubMed]