For extensive impetigo with fever, which systemic antibiotic options may be used?

For extensive impetigo with fever, which systemic antibiotic options may be used?

• A. Cephalexin
• B. Nystatin
• C. Azathioprine
• D. Acetaminophen

Answer: (D)

When impetigo is extensive and fever is present, the infection is treated as a systemic issue rather than just a few surface lesions. A systemic antibiotic is indicated because it reaches bacteria beyond the superficial skin and helps resolve the infection and fever. Cephalexin fits best here because it’s a first-generation cephalosporin with good activity against the usual culprits in impetigo—Staphylococcus aureus and Streptococcus pyogenes—and it’s commonly used in children for outpatient systemic therapy. Nystatin is ineffective against bacteria and targets fungal infections. Azathioprine is an immunosuppressant, not an antimicrobial. Acetaminophen can help reduce fever and pain but does not treat the bacterial infection itself; it’s only supportive care alongside an active antibiotic. So, the systemic antibiotic option that may be used is cephalexin. If MRSA or penicillin allergy are concerns, alternatives exist, but the key point is that an antibiotic like cephalexin is appropriate, not the non-antibiotic options.

When impetigo is extensive and fever is present, the infection is treated as a systemic issue rather than just a few surface lesions. A systemic antibiotic is indicated because it reaches bacteria beyond the superficial skin and helps resolve the infection and fever.

Cephalexin fits best here because it’s a first-generation cephalosporin with good activity against the usual culprits in impetigo—Staphylococcus aureus and Streptococcus pyogenes—and it’s commonly used in children for outpatient systemic therapy.

Nystatin is ineffective against bacteria and targets fungal infections. Azathioprine is an immunosuppressant, not an antimicrobial. Acetaminophen can help reduce fever and pain but does not treat the bacterial infection itself; it’s only supportive care alongside an active antibiotic.

So, the systemic antibiotic option that may be used is cephalexin. If MRSA or penicillin allergy are concerns, alternatives exist, but the key point is that an antibiotic like cephalexin is appropriate, not the non-antibiotic options.