(Non-bullous impetigo, for adults and children aged 1 year and over)
Does the patient meet ANY of the following:
Risk of deterioration, red flags or serious illness
Immunosuppressed and infection is widespread
Severe complications suspected (e.g. deeper soft tissue infection)
Gateway Point
Consider calculating NEWS2 Score ahead of signposting patient to A&E or calling 999.
Does the patient follow typical progression of impetigo features?
• Initial lesion is a very thin-walled vesicle on an erythematous base
• Exudate dries to form golden yellow or yellow-brown crusts
• Common on exposed skin on the face, limbs and flexures
• Satellite lesions may develop following autoinoculation
Consider alternative diagnosis and proceed appropriately.
How many lesions/clusters are present?
Localised non-bullous impetigo
Offer hydrogen peroxide 1% cream for 5 days plus self-care.
If unsuitable/ineffective
Offer fusidic acid cream for 5 days plus self-care.
Widespread non-bullous impetigo
Offer flucloxacillin (if no allergy) for 5 days plus self-care.