Acyclovir and Impetigo: What You Need to Know
No, acyclovir is not effective for impetigo.
Why
- Acyclovir is a nucleoside analogue antiviral active against herpesviruses (HSV-1/2, VZV). It requires viral thymidine kinase for phosphorylation.
- Impetigo is a bacterial infection caused by Staphylococcus aureus (bullous and non-bullous) or Streptococcus pyogenes (non-bullous). Bacteria lack thymidine kinase and are unaffected by acyclovir.
Correct Treatment for Impetigo
| Severity | Treatment |
|---|---|
| Localized, non-bullous | Topical mupirocin 2% or retapamulin 1% ointment TID × 5–7 days |
| Extensive, bullous, or systemic symptoms | Oral cephalexin 25–50 mg/kg/day ÷ QID, dicloxacillin, or clindamycin (if MRSA risk) × 7 days |
Key Points
- Hygiene: gentle cleansing, remove crusts, cover lesions.
- Exclude from school/daycare until 24h on antibiotics.
- Decolonization (mupirocin intranasal, chlorhexidine baths) for recurrent/family cases.
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