Fusidic acid cream for impetigo: Authors’ reply

Guidelines for treating impetigo may vary between countries or regions. The wish to reserve certain antibiotics for specific vital conditions, and local resistance rates, may vary and lead to different recommendations. The letters commenting on our article focus on the question of whether the use of fusidic acid cream should be promoted in the United Kingdom in light of the higher reported staphylococcal resistance rates to fusidic acid in the United Kingdom and the risk of rising resistance rates because of its use. The main purpose of our study was to assess the effectiveness of fusidic acid cream in impetigo compared with disinfection with povidone iodine alone. The large treatment effect we found may partly be explained by the low resistance rate to fusidic acid, which was an unexpected co-finding. We used Vitek II equipment to test the susceptibility of isolates, using the guidelines of the national committee for clinical laboratory standards to categorise strains as resistant, intermediately sensitive, or sensitive, as described in the website version of our article. [...