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Impetigo incidence and treatment: a retrospective study of Dutch routine primary care data.

Authors
  • Loadsman, Madelyn E N1, 2
  • Verheij, Theo J M3
  • van der Velden, Alike W3
  • 1 School of Medicine, Griffith University, Brisbane, Australia. , (Australia)
  • 2 Logan Hospital, Queensland Health, Queensland, Australia. , (Australia)
  • 3 Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands. , (Netherlands)
Type
Published Article
Journal
Family Practice
Publisher
Oxford University Press
Publication Date
Jul 31, 2019
Volume
36
Issue
4
Pages
410–416
Identifiers
DOI: 10.1093/fampra/cmy104
PMID: 30346521
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

There is a lack of recently published data on impetigo presentation incidence and treatment practices in the routine Western European primary care setting. To investigate impetigo incidence, treatments and recurrence in primary care in the Netherlands. A retrospective, observational study. Electronic records of patients treated for impetigo in 2015 at 29 general practices in Utrecht and surrounds were reviewed. An episode of impetigo was defined as one or more patient-doctor contacts within 8 weeks of the index consultation. Within an episode, patient demographics and prescribing patterns were analysed including number of treatments, and the category and sequence of individual medicines. A total of 1761 impetigo episodes were managed, with an incidence rate of 13.6 per 1000 person years. Impetigo peaked in summer. Most patients, the majority children, experienced a single episode (93%), and 25% had eczema as comorbidity. Topical antibiotics (primarily fusidic acid) were the most prescribed initial treatments (85%), followed by oral antibiotics (14%). Topical antibiotics were progressively used less over subsequent treatments, while there was an inverse increase in oral antibiotic use. Topical fusidic acid as the most common first line treatment seemed satisfactory as only 12% of initial treatments with this drug received further therapy. Repeat treatments generally occurred within 7 days. This study of impetigo prescribing patterns in primary care highlighted that Dutch general practitioners were generally adherent to national treatment guidelines. Topical treatment, and if needed systemic small-spectrum antibiotic treatment, appeared satisfactory; these findings aid in antimicrobial stewardship. © The Author(s) 2018. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: [email protected]

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