Seventy-three children with impetigo were randomly assigned to receive penicillin V potassium or cephalexin monohydrate, both administered at dosages of 40 to 50 mg/kg per day, or erythromycin estolate administered at a dosage of 30 to 40 mg/kg per day 1. All drugs were given in three divided doses for 10 days. Treatment failure was defined as persistence of lesions 8 to 10 days after initiation of drug therapy as determined by examiners blinded to the treatment therapies. Forty-five (62%) cultures showed Staphylococcus aureus only, 14 (19%) showed S. aureus and group A beta-haemolytic streptococci, six (8%) showed group A beta-haemolytic streptococci only, and eight (11%) showed no growth or other organisms. Treatment failure occurred in six (24%) of 25 patients treated with penicillin V, one (4%) of 25 patients treated with erythromycin estolate, and no patients treated with cephalexin.
Comment: The quality of evidence is downgraded by imprecise results (only one small trial was included).
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