# Impetigo (localized and systemic) - Category: infectious - Review status: reviewed (every claim checked against a document named on this page) - Sources: Impetigo - StatPearls - NCBI Bookshelf (NBK430974) - disease-level clinical article (impetigo-full.txt) · Egyptian Drug Authority - National Guidance of Rational Antimicrobial Use in the Management of Skin and Soft Tissue Infection, EDREX:GU.CAP.Care.015 version 1, 11/2025 · Egyptian National Drug Formulary - antimicrobial-2023.pdf, Clindamycin monograph (chapter PDF p287) · Egyptian National Drug Formulary - Antimicrobial 2023 (doxycycline monograph) · Egyptian National Drug Formulary - Antimicrobial 2023, sulfamethoxazole and trimethoprim monograph · Egyptian National Drug Formulary - Antimicrobial 2023 (cefadroxil monograph) · Fucidin 20 mg/g Cream (fusidic acid) SmPC sections 4.1 and 4.2 (eMC product 5510) · Mupirocin ointment USP 2% US prescribing information (DailyMed SetID b8e115ce-c8ff-4d08-b865-71dc4d0e51a1) - Verified date: 2026-08 ## Verified against - Impetigo - StatPearls - NCBI Bookshelf (NBK430974) - disease-level clinical article (impetigo-full.txt) - Egyptian Drug Authority - National Guidance of Rational Antimicrobial Use in the Management of Skin and Soft Tissue Infection, EDREX:GU.CAP.Care.015 version 1, 11/2025 - Egyptian National Drug Formulary - antimicrobial-2023.pdf, Clindamycin monograph (chapter PDF p287) - Egyptian National Drug Formulary - Antimicrobial 2023 (doxycycline monograph) - Egyptian National Drug Formulary - Antimicrobial 2023, sulfamethoxazole and trimethoprim monograph - Egyptian National Drug Formulary - Antimicrobial 2023 (cefadroxil monograph) - Fucidin 20 mg/g Cream (fusidic acid) SmPC sections 4.1 and 4.2 (eMC product 5510) - Mupirocin ointment USP 2% US prescribing information (DailyMed SetID b8e115ce-c8ff-4d08-b865-71dc4d0e51a1) ## Treatment metadata - Fusidic acid — topical - Mupirocin — topical - Cefadroxil — 500 mg — oral.solid - Clindamycin — 300 mg — oral.solid - Doxycycline — 100 mg — oral.solid - Sulphamethoxazole + Trimethoprim — oral.solid ## Complete treatment card ```text IMPETIGO (LOCALIZED AND SYSTEMIC) Sources: Impetigo - StatPearls - NCBI Bookshelf (NBK430974) - disease-level clinical article (impetigo-full.txt) · Egyptian Drug Authority - National Guidance of Rational Antimicrobial Use in the Management of Skin and Soft Tissue Infection, EDREX:GU.CAP.Care.015 version 1, 11/2025 · Egyptian National Drug Formulary - antimicrobial-2023.pdf, Clindamycin monograph (chapter PDF p287) · Egyptian National Drug Formulary - Antimicrobial 2023 (doxycycline monograph) · Egyptian National Drug Formulary - Antimicrobial 2023, sulfamethoxazole and trimethoprim monograph · Egyptian National Drug Formulary - Antimicrobial 2023 (cefadroxil monograph) · Fucidin 20 mg/g Cream (fusidic acid) SmPC sections 4.1 and 4.2 (eMC product 5510) · Mupirocin ointment USP 2% US prescribing information (DailyMed SetID b8e115ce-c8ff-4d08-b865-71dc4d0e51a1) Review status: REVIEWED against 5 sources listed above (2026-08) IS IT THIS? - reference only, to read alongside your own examination SYMPTOMS - what the patient reports (3) - It usually shows as red plaques with a yellow crust, and it can itch or hurt [itching · redness] - It is highly contagious and passes easily, from person to person and from site to site - This is above all a childhood disease of hot humid climates SIGNS - what you find (8) - Nonbullous impetigo starts as vesicles or pustules that merge and rupture, leaving a honey- coloured crust on a red base [blisters · crusting · pustules · vesicles] - Rapid spread with satellite lesions from self-inoculation is typical, often on skin with no visible break [skin lesions] - Mild regional lymph node swelling is common, but fever is usually absent in the nonbullous form [lymphadenopathy] - Bullous impetigo has flaccid, clear-to-yellow blisters with no surrounding redness or lymph node swelling, and it never forms the honey crust [blisters] - Fever is more common with the bullous form than the nonbullous form, though it tends to have fewer lesions [blisters · fever] - Ecthyma produces deep, punched-out ulcers with a violet-tinged border reaching into the dermis - The infection sits in the top layers of the epidermis and is nearly always due to gram- positive bacteria - The face is the usual site, but it takes anywhere the skin is broken: a graze, a cut, an insect bite or any other injury TESTS (4) - Bacterial culture confirms the diagnosis and is warranted when MRSA is suspected or during an outbreak - Streptococcal antibody testing doesn't help diagnose impetigo itself, only later if post-strep kidney inflammation is suspected - Consider checking for HIV in an adult with no prior skin disease who newly develops bullous- type lesions - The diagnosis is made on the appearance and the story alone IF NOT THIS - what else fits (2) - Atopic dermatitis, scabies and contact dermatitis are also on the differential - Herpes simplex, candidiasis and varicella zoster round out the differential list Source StatPearls "Impetigo" - disease-level clinical article Status traced to the source above Rx: Main treatment | Oral antibiotic - widespread or bullous disease | Oral antibiotic - when MRSA is suspected or confirmed MAIN TREATMENT - choose one 1. FUSIDIC ACID [1st line] Adult Apply 2% cream or ointment TID to affected lesions x 5 days Peds Apply 2% cream or ointment TID to affected lesions for 5 days Choice Alternatives. The entry names fusidic acid first-line for localised non-bullous impetigo, with mupirocin kept for suspected fusidic-acid resistance. Source Fucidin 20 mg/g Cream (fusidic acid) SmPC sections 4.1 and 4.2 (eMC product 5510): "Fucidin 20 mg/g cream is indicated either alone or in combination with systemic therapy, in the treatment of primary and secondary skin infections caused by sensitive strains of Staphylococcus aureus, Streptococcus spp and Corynebacterium minutissimum." and "Uncovered lesions - apply gently three or four times daily." The 5-day course sits inside that frequency; the SmPC states no duration. Why First-line topical treatment for localized non-bullous impetigo Caution Limit treatment to 5-7 days to prevent bacterial resistance. Avoid application near the eyes. Wash hands before and after application. Egypt FOSTINO 2% TOPICAL GEL 15 GM ZAD 8.00 EGP ANESTY 2% TOPICAL GEL 15GM MARCYRL PHARM... 8.50 EGP FUSIDIC ACID 2% GEL 15 GM SIGMA 8.50 EGP FUSIDICTAM 2 % TOP. CREAM 30 GM MEDIZEN PHARM... 26.50 EGP FUCI-TOP 2% CREAM 15 GM HIKMA PHARMA 44.00 EGP FUCIDIN 2% CREAM 15 GM MINA PHARM > ... 56.00 EGP FUCIDIN 2% CREAM 30 GM MINA PHARM > ... 96.00 EGP FUCIDIN 2% OINTMENT 30 GM MINA PHARM > ... 96.00 EGP 2. MUPIROCIN [1st line] Adult Apply 2% ointment TID to affected skin area x 5 days Peds Apply 3 times a day for 5 days. Licenses for mupirocin use in infants vary between products; check individual SPCs. Source Mupirocin ointment USP 2% US prescribing information, INDICATIONS AND USAGE and DOSAGE AND ADMINISTRATION (DailyMed SetID b8e115ce-c8ff-4d08-b865-71dc4d0e51a1): "Mupirocin ointment is indicated for the topical treatment of impetigo due to susceptible isolates of Staphylococcus aureus and Streptococcus pyogenes." and "Apply a small amount of mupirocin ointment, with a cotton swab or gauze pad, to the affected area 3 times daily for up to 10 days." The 5-day course sits inside the label's 10-day ceiling. Why Alternative topical treatment when fusidic acid resistance is suspected Caution Do not use in nasal passages unless using specific nasal formulation. Avoid prolonged use (>7 days) to reduce risk of resistance. Local skin reactions (burning, stinging) may occur. Egypt BACTROFORM 2% TOP. OINT. 15 GM WESTERN PHARM... 35.00 EGP MUPIROCIN SAJA 2% TOP. OINT. 15 GM BIOPHARM EGYPT > SAJA PHARMA 35.00 EGP MUPIRAX 2% OINT. 10 GM GLOBAL NAPI P... 48.00 EGP MUPIROCIN SAJA 2% TOP. OINT. 20 GM BIOPHARM EGYPT > SAJA PHARMA 83.00 EGP MUPIRAX 2% OINT. 30 GM GLOBAL NAPI P... 118.00 EGP ORAL ANTIBIOTIC - WIDESPREAD OR BULLOUS DISEASE 3. CEFADROXIL [2nd line] Adult 500 mg BID for widespread or severe impetigo Peds 30 mg/kg/day [child max 1000 mg] (30 mg/kg/day in 2 divided doses for widespread impetigo) 3kg -> 90 mg/day 4kg -> 120 mg/day 5kg -> 150 mg/day 6kg -> 180 mg/day 7kg -> 210 mg/day 8kg -> 240 mg/day 9kg -> 270 mg/day 10kg -> 300 mg/day 11kg -> 330 mg/day 12kg -> 360 mg/day 13kg -> 390 mg/day 14kg -> 420 mg/day 15kg -> 450 mg/day 16kg -> 480 mg/day 17kg -> 510 mg/day 18kg -> 540 mg/day 19kg -> 570 mg/day 20kg -> 600 mg/day 21kg -> 630 mg/day 22kg -> 660 mg/day 23kg -> 690 mg/day 24kg -> 720 mg/day 25kg -> 750 mg/day 26kg -> 780 mg/day 27kg -> 810 mg/day 28kg -> 840 mg/day 29kg -> 870 mg/day 30kg -> 900 mg/day 31kg -> 930 mg/day 32kg -> 960 mg/day 33kg -> 990 mg/day 34kg -> 1000 mg/day (capped) 35kg -> 1000 mg/day (capped) 36kg -> 1000 mg/day (capped) 37kg -> 1000 mg/day (capped) 38kg -> 1000 mg/day (capped) 39kg -> 1000 mg/day (capped) 40kg -> 1000 mg/day (capped) 41kg -> 1000 mg/day (capped) 42kg -> 1000 mg/day (capped) 43kg -> 1000 mg/day (capped) 44kg -> 1000 mg/day (capped) 45kg -> 1000 mg/day (capped) 46kg -> 1000 mg/day (capped) 47kg -> 1000 mg/day (capped) 48kg -> 1000 mg/day (capped) 49kg -> 1000 mg/day (capped) 50kg -> 1000 mg/day (capped) Source Egyptian National Drug Formulary - Antimicrobial 2023 (cefadroxil monograph) Why Oral antibiotic for widespread or complicated impetigo Caution Reserve oral antibiotics for widespread, recurrent, or systemic disease. Caution in penicillin allergy. Gastrointestinal upset may occur. Egypt MEGADROXIL 500 MG 8 CAPS. SHIFA MEDICAL... 4.50 EGP (0.56/unit) CEFADROXIL 500MG 8 CAPS. SIGMA 7.50 EGP (0.94/unit) DURABIOTIC 500MG 8 CAPS. LOGESTIC PHAR... 9.00 EGP (1.12/unit) BIODROXIL 500MG 8 CAPS. KAHIRA > NOVA... 10.50 EGP (1.31/unit) LONGICEF 500 MG 8 CAPS. KAHIRA 15.00 EGP (1.88/unit) CURISAFE 500MG 8 CAPS. PHARCO B 45.00 EGP (5.62/unit) DURICEF 500MG 12 CAPS. SMITHKLINE BE... 72.00 EGP (6.00/unit) LONGICEF 125MG/5ML SUSP. 60 ML KAHIRA 4.25 EGP -> ? strength differs, ? different route - not oral solid CEFADROXIL 250MG/5ML PD. FOR ORAL SUSP. 60ML SIGMA 7.50 EGP -> ? strength differs, ? different route - not oral solid ORAL ANTIBIOTIC - WHEN MRSA IS SUSPECTED OR CONFIRMED - choose one 4. CLINDAMYCIN [2nd line] Adult 150 to 300 mg every 6 hours by mouth, rising to 300 to 450 mg every 6 hours in more severe disease x 7 days Peds 8-20 mg/kg/day (8 to 20 mg/kg/day by mouth, divided every 6 to 8 hours, using the capsule (hydrochloride) salt. Not for infants under one month.) 3kg -> 24-60 mg/day 4kg -> 32-80 mg/day 5kg -> 40-100 mg/day 6kg -> 48-120 mg/day 7kg -> 56-140 mg/day 8kg -> 64-160 mg/day 9kg -> 72-180 mg/day 10kg -> 80-200 mg/day 11kg -> 88-220 mg/day 12kg -> 96-240 mg/day 13kg -> 104-260 mg/day 14kg -> 112-280 mg/day 15kg -> 120-300 mg/day 16kg -> 128-320 mg/day 17kg -> 136-340 mg/day 18kg -> 144-360 mg/day 19kg -> 152-380 mg/day 20kg -> 160-400 mg/day 21kg -> 168-420 mg/day 22kg -> 176-440 mg/day 23kg -> 184-460 mg/day 24kg -> 192-480 mg/day 25kg -> 200-500 mg/day 26kg -> 208-520 mg/day 27kg -> 216-540 mg/day 28kg -> 224-560 mg/day 29kg -> 232-580 mg/day 30kg -> 240-600 mg/day 31kg -> 248-620 mg/day 32kg -> 256-640 mg/day 33kg -> 264-660 mg/day 34kg -> 272-680 mg/day 35kg -> 280-700 mg/day 36kg -> 288-720 mg/day 37kg -> 296-740 mg/day 38kg -> 304-760 mg/day 39kg -> 312-780 mg/day 40kg -> 320-800 mg/day 41kg -> 328-820 mg/day 42kg -> 336-840 mg/day 43kg -> 344-860 mg/day 44kg -> 352-880 mg/day 45kg -> 360-900 mg/day 46kg -> 368-920 mg/day 47kg -> 376-940 mg/day 48kg -> 384-960 mg/day 49kg -> 392-980 mg/day 50kg -> 400-1000 mg/day Choice Alternatives, and clindamycin is the one to reach for first. It is the only one of the three the Egyptian formulary lists for skin and soft tissue infection outright, it covers streptococcus as well as MRSA, and it has a paediatric oral dose with no age floor beyond the newborn - which matters on a disease most often seen in children. Doxycycline is reserved above 8 years, and co-trimoxazole cannot be relied on against group A streptococcus. Source Egyptian Drug Authority - National Guidance of Rational Antimicrobial Use in the Management of Skin and Soft Tissue Infection, EDREX:GU.CAP.Care.015 version 1, 11/2025 - verbatim, on impetigo: "When MRSA is suspected or confirmed: One of the following: Doxycycline. SMX-TMP. Clindamycin", with the course length "Oral therapy for ecthyma or impetigo should be a7-day." and the adult dose "300-400 mg 4 times per day po." / "MRSA: 600-900 mg every 8 h IV or 300 mg 4 times daily or 450 mg 3 times." | Egyptian National Drug Formulary - antimicrobial-2023.pdf, Clindamycin monograph (chapter PDF p287) - verbatim, for the indication and the paediatric dose: "Skin and soft tissue infection: Treatment of skin and soft tissue infection" and "Oral: Infants, Children, and Adolescents: Hydrochloride salt (capsule): 8 to 20 mg/kg/day divided every 6 to 8 hours." Why Covers methicillin-resistant Staphylococcus aureus and Streptococcus pyogenes in one drug, which matters in impetigo because streptococcus causes a large share of it. Caution Watch the bowels. Clindamycin carries the clearest Clostridioides difficile risk of the three options here - the formulary lists antibiotic-associated colitis and pseudomembranous colitis, and asks prescribers to observe for changes in bowel frequency. New or worsening diarrhoea during or after the course is a reason to stop and reassess, not to wait it out. Not in infants under one month. The 1% topical solution and gel sold in Egypt are acne preparations and are a different treatment from this one - the oral capsule is what this dose refers to. Egypt ADCOCLINDACE 300 MG 16 CAPS. ARAB DRUG COM... 24.00 EGP (1.50/unit) CLINACYN 300MG 16 CAPS. SIGMA > EGYPT... 31.50 EGP (1.97/unit) CLINDAM 300 MG 16 CAPS. SIGMA > OCTOB... 75.00 EGP (4.69/unit) MEPACLIND 300MG 8 CAPS. MEPACO 38.00 EGP (4.75/unit) CLINDACINE ART 300 MG 12 CAPS. RAMEDA > ART ... 76.00 EGP (6.33/unit) ALFACLINDAMYCIN 300 MG 10 CAPS. ATCO PHARMA >... 69.00 EGP (6.90/unit) DALACIN C 300MG 10 CAPS. PFIZER 114.00 EGP (11.40/unit) KLENDABIOTICAM 1 % TOP. SOLUTION PANAX PHARMA 8.50 EGP -> ? strength differs, ? different route - not oral solid ADCOCLINDACE 10MG/ML TOP. SOL. ARAB DRUG COM... 12.00 EGP -> ? strength differs, ? different route - not oral solid 5. DOXYCYCLINE [2nd line] Adult 100 mg twice daily by mouth x 7 days Peds 2.2 mg/kg/dose [child max 100 mg] (2.2 mg/kg per dose every 12 hours, never above 100 mg in a dose - but see the age restriction in the cautions before using this in a child.) 3kg -> 6.6 mg/dose 4kg -> 8.8 mg/dose 5kg -> 11 mg/dose 6kg -> 13.2 mg/dose 7kg -> 15.4 mg/dose 8kg -> 17.6 mg/dose 9kg -> 19.8 mg/dose 10kg -> 22 mg/dose 11kg -> 24.2 mg/dose 12kg -> 26.4 mg/dose 13kg -> 28.6 mg/dose 14kg -> 30.8 mg/dose 15kg -> 33 mg/dose 16kg -> 35.2 mg/dose 17kg -> 37.4 mg/dose 18kg -> 39.6 mg/dose 19kg -> 41.8 mg/dose 20kg -> 44 mg/dose 21kg -> 46.2 mg/dose 22kg -> 48.4 mg/dose 23kg -> 50.6 mg/dose 24kg -> 52.8 mg/dose 25kg -> 55 mg/dose 26kg -> 57.2 mg/dose 27kg -> 59.4 mg/dose 28kg -> 61.6 mg/dose 29kg -> 63.8 mg/dose 30kg -> 66 mg/dose 31kg -> 68.2 mg/dose 32kg -> 70.4 mg/dose 33kg -> 72.6 mg/dose 34kg -> 74.8 mg/dose 35kg -> 77 mg/dose 36kg -> 79.2 mg/dose 37kg -> 81.4 mg/dose 38kg -> 83.6 mg/dose 39kg -> 85.8 mg/dose 40kg -> 88 mg/dose 41kg -> 90.2 mg/dose 42kg -> 92.4 mg/dose 43kg -> 94.6 mg/dose 44kg -> 96.8 mg/dose 45kg -> 99 mg/dose 46kg -> 100 mg/dose (capped) 47kg -> 100 mg/dose (capped) 48kg -> 100 mg/dose (capped) 49kg -> 100 mg/dose (capped) 50kg -> 100 mg/dose (capped) Source Egyptian Drug Authority - National Guidance of Rational Antimicrobial Use in the Management of Skin and Soft Tissue Infection, EDREX:GU.CAP.Care.015 version 1, 11/2025 - verbatim, on impetigo: "When MRSA is suspected or confirmed: One of the following: Doxycycline.", with the course length "Oral therapy for ecthyma or impetigo should be a7-day." and the adult dose "100 mg orally or IV 2 times per day." | Egyptian National Drug Formulary - Antimicrobial 2023 (doxycycline monograph) - verbatim, for the paediatric dose: "Children and Adolescents: Oral, IV: 2.2 mg/kg/dose every 12 hours, maximum dose: 100 mg/dose." Why An MRSA-active oral option that is stocked everywhere in Egypt and costs a few pounds a course. Caution Under 8 years, the formulary reserves doxycycline for severe, potentially life- threatening infection or where there is no better alternative. Impetigo in a young child is neither, so clindamycin is the option to use instead. The formulary itself does not rate doxycycline as the preferred drug for any staphylococcal infection - it is included here because it is active against MRSA, not because it is the best anti-staphylococcal option. Avoid in the second and third trimesters of pregnancy and while breastfeeding. Egypt FARCODOXIN 100MG 10 CAPS. PHARCO 11.00 EGP (1.10/unit) DOXY M.R.100 MG 10 CAPS. ADWIA 12.00 EGP (1.20/unit) GRANUDOXY 100MG 10 F.C. TAB. GLOBAL NAPI P... 12.00 EGP (1.20/unit) DOXYDOX 100 MG 10 CAPS. EIPICO 23.00 EGP (2.30/unit) DOXYMYCIN 100 MG 10 CAPS. EL NILE. 30.00 EGP (3.00/unit) TABOCINE 100MG 10 CAPS. TABUK PHARMAC... 46.00 EGP (4.60/unit) VIBRAMYCIN 100MG 10 CAPS. PFIZER 65.00 EGP (6.50/unit) 6. SULPHAMETHOXAZOLE + TRIMETHOPRIM [2nd line] Adult 1 to 2 double-strength tablets (800 mg sulphamethoxazole with 160 mg trimethoprim) twice daily x 7 days Peds 6-12 mg/kg/day [child max 320 mg] (6 to 12 mg/kg/day divided every 12 hours, counted on the TRIMETHOPRIM component alone, not on the combined tablet weight, to a ceiling of 160 mg of trimethoprim in a single dose. The 200/40 mg per 5 mL suspension carries 40 mg of trimethoprim in each 5 mL. Not under 2 months of age.) 3kg -> 18-36 mg/day 4kg -> 24-48 mg/day 5kg -> 30-60 mg/day 6kg -> 36-72 mg/day 7kg -> 42-84 mg/day 8kg -> 48-96 mg/day 9kg -> 54-108 mg/day 10kg -> 60-120 mg/day 11kg -> 66-132 mg/day 12kg -> 72-144 mg/day 13kg -> 78-156 mg/day 14kg -> 84-168 mg/day 15kg -> 90-180 mg/day 16kg -> 96-192 mg/day 17kg -> 102-204 mg/day 18kg -> 108-216 mg/day 19kg -> 114-228 mg/day 20kg -> 120-240 mg/day 21kg -> 126-252 mg/day 22kg -> 132-264 mg/day 23kg -> 138-276 mg/day 24kg -> 144-288 mg/day 25kg -> 150-300 mg/day 26kg -> 156-312 mg/day 27kg -> 162-320 mg/day (upper capped) 28kg -> 168-320 mg/day (upper capped) 29kg -> 174-320 mg/day (upper capped) 30kg -> 180-320 mg/day (upper capped) 31kg -> 186-320 mg/day (upper capped) 32kg -> 192-320 mg/day (upper capped) 33kg -> 198-320 mg/day (upper capped) 34kg -> 204-320 mg/day (upper capped) 35kg -> 210-320 mg/day (upper capped) 36kg -> 216-320 mg/day (upper capped) 37kg -> 222-320 mg/day (upper capped) 38kg -> 228-320 mg/day (upper capped) 39kg -> 234-320 mg/day (upper capped) 40kg -> 240-320 mg/day (upper capped) 41kg -> 246-320 mg/day (upper capped) 42kg -> 252-320 mg/day (upper capped) 43kg -> 258-320 mg/day (upper capped) 44kg -> 264-320 mg/day (upper capped) 45kg -> 270-320 mg/day (upper capped) 46kg -> 276-320 mg/day (upper capped) 47kg -> 282-320 mg/day (upper capped) 48kg -> 288-320 mg/day (upper capped) 49kg -> 294-320 mg/day (upper capped) 50kg -> 300-320 mg/day (upper capped) Source Egyptian Drug Authority - National Guidance of Rational Antimicrobial Use in the Management of Skin and Soft Tissue Infection, EDREX:GU.CAP.Care.015 version 1, 11/2025 - verbatim, on impetigo: "When MRSA is suspected or confirmed: One of the following: ... SMX-TMP.", with the course length "Oral therapy for ecthyma or impetigo should be a7-day." and the adult dose "1 or 2 double-strength tablets 2 times per day." | Egyptian National Drug Formulary - Antimicrobial 2023, sulfamethoxazole and trimethoprim monograph - verbatim, for the paediatric dose: "General dosing, susceptible infection: Infants >=2 months, Children, and Adolescents: Oral, IV: 6 to 12 mg TMP/kg/day in divided doses every 12 hours; maximum single dose: 160 mg TMP/dose" Why MRSA-active, widely stocked and cheap - but the narrowest of the three options here, because it cannot be relied on against streptococcus. Caution Use only where group A streptococcus is not the cause, or together with a drug that covers streptococcus. The disease article is explicit that co-trimoxazole is limited to cases where group A streptococci are ruled out, or given alongside an anti-streptococcal antibiotic. Streptococcus accounts for a large share of impetigo, so this is a real limit, not a footnote. Contraindicated under 2 months of age, and in pregnancy and breastfeeding. Causes haemolysis in G6PD deficiency, which is common enough in Egypt to ask about before prescribing. Contraindicated in a known sulfonamide allergy, in megaloblastic anaemia from folate deficiency, and in marked liver damage. Egypt CO-TRIMOXAZOLE 20 TABS. MUP 5.00 EGP (0.25/unit) COTRIL 400/80MG 20 TAB. EL NASR 38.00 EGP (1.90/unit) SEPTAZOLE FORTE 800/160MG 20 TABS. ALEXANDRIA 56.00 EGP (2.80/unit) SEPTRIN D.S 10 TABS. GLAXO SMITHKL... 28.00 EGP (2.80/unit) SEPTAZOLE 400/80MG 20*10 TABS. ALEXANDRIA 340.00 EGP (34.00/unit) SUTRIM 400/80MG 20*10 TAB. MEMPHIS 340.00 EGP (34.00/unit) CO-TRIMOXAZOLE 200/40MG SUSP. 120ML MUP 6.00 EGP -> ? strength differs, ? different route - not oral solid SUTRIM 200/40MG SUSP. 100ML MEMPHIS 18.50 EGP -> ? strength differs, ? different route - not oral solid Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy. ``` --- Dawaa Reference is a reference for prescribers, not a medical device, and does not replace clinical judgement. [Privacy policy](/privacy)