What is the first-line topical treatment for a child with localized impetigo?

Topical mupirocin is the first-line treatment for localized impetigo due to its effective antibacterial properties against the most common causative organisms, which are Staphylococcus aureus and Streptococcus pyogenes. Mupirocin works by inhibiting bacterial protein synthesis, making it particularly effective in treating skin infections like impetigo where rapid antibacterial action is needed to clear the infection while minimizing potential scarring and complications.

Mupirocin is favored for its potency against the typical bacteria involved in impetigo and its broader spectrum of action compared to other topical antibiotics. Moreover, it is generally well-tolerated and has a low risk of causing allergic reactions, which is especially important in pediatric populations.

In contrast, other topical antibiotics such as bacitracin, neomycin, and polymyxin B are less effective for impetigo. Bacitracin has limited activity against Staphylococcus aureus, and while it may be used for minor skin infections, it is not as robust as mupirocin for impetigo. Neomycin, though effective against some gram-negative bacteria, has a higher propensity to cause allergic dermatitis, making it a less ideal option for children who may have sensitive skin. Topical polymyxin