For extensive, severe, or bullous impetigo, use oral antibiotics. 

Reserve topical antibiotics for very localised lesions & avoid repeated courses to reduce the risk of resistance.

If localised:

Fusidic acid 2% cream


topically 3 to 4 x daily


5 days

Only if MRSA

Mupirocin 2% ointment


topically 3 x daily


5 days

If widespread

oral Flucloxacillin


500mg 4 x daily 

child dose


7 days

If penicillin allergic:

oral Clarithromycin


500mg 2 x daily 

child dose


7 days