What is the first line treatment for nonbullous impetigo?

The first line treatment for nonbullous impetigo is topical antibiotics. This condition, which is often caused by Staphylococcus aureus or Streptococcus pyogenes, typically presents as honey-colored crusted lesions that commonly affect the face and extremities. Topical antibiotics, such as mupirocin or retapamulin, are favored for localized cases because they are effective at delivering the antimicrobial agent directly to the site of infection while minimizing systemic side effects.

Using topical antibiotics is particularly advantageous in nonbullous impetigo since the lesions are usually localized and can be treated effectively without the need for systemic therapy. In most cases, this approach leads to rapid resolution of symptoms and clearance of the infection, making it both a practical and efficacious choice for management.

Oral antibiotics are reserved for more extensive infections or in cases where the lesions are widespread or present in patients with systemic symptoms. Antifungal creams are not applicable in this case, as impetigo is a bacterial infection, not a fungal one. Systemic corticosteroids do not address the underlying infection and are not indicated for treating impetigo. Thus, utilizing topical antibiotics stands out as the best initial treatment for nonbullous impetigo.