👶 Paediatric Pearl: Impetigo doesn’t always need antibiotics 🧴

For localised, non-bullous impetigo, CKS recommends hydrogen peroxide 1% (Crystacide) as first line.

🔍 When Crystacide is enough:

Mild, localised impetigo

Few lesions

Child otherwise well

No systemic symptoms

🧼 Management basics:

Gentle crust removal (warm water)

Apply Crystacide 2–3 times daily for 5 days

Good hand hygiene

Avoid sharing towels or flannels

💊 Reserve topical or oral antibiotics for:

Extensive or spreading disease

Bullous impetigo

Systemic symptoms

Treatment failure

High-risk children

💡 Why this matters:

Reduces antibiotic resistance

Aligns with NICE and CKS guidance

Simple, effective, and parent-friendly

Sometimes less really is more.

👉 Are parents receptive when you suggest Crystacide instead of antibiotics?

For me the first few were after that most parents were easy. Using the term antimicrobial cream helps!

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