Empiric Therapy Regimens
Empiric therapeutic regimens for impetigo are outlined below, including those for localized, uncomplicated impetigo and those for widespread, or complicated, impetigo.
Impetigo is a contagious, superficial bacterial infection commonly seen in children. Treatment typically involves local wound care along with topical or systemic antibiotic therapy with activity against beta-hemolytic streptococci and Staphylococcus aureus.
Topical therapy is preferred for localized, uncomplicated nonbullous or bullous impetigo.  Systemic antibiotics are used for widespread infections, complicated infections, outbreaks of poststreptococcal glomerulonephritis, or multiple incidents that have occurred within the home, daycare, or athletic-team settings. The duration of therapy should be based on clinical improvement; however, a 7-day regimen is recommended.  As S aureus isolates from impetigo are usually methicillin-susceptible, cephalexin, amoxicillin-clavulanate, or dicloxacillin is usually recommended. Trimethoprim-sulfamethoxazole, clindamycin, or doxycycline is recommended for confirmed or highly suspected MRSA impetigo.
The Infectious Diseases Society of America (IDSA) published 2014 guidelines for the treatment of impetigo (see Practice Guidelines for the Diagnosis and Management of Skin and Soft Tissue Infections: 2014 Update by the Infectious Diseases Society of America). 
Localized, uncomplicated impetigo
Localized, uncomplicated impetigo is treated as follows:
Topical wound cleansing
Mupirocin 2% cream/ointment applied topically BID for 5 days or
Retapamulin 1% ointment applied topically BID for 5 days
Widespread (complicated) impetigo is treated as follows:
Cephalexin 250 mg PO QID for 7 days in adults or 25 mg/kg/day in 4 divided doses for 7 days in children or
Dicloxacillin 250 mg PO QID for 7 days in adults/children >40 kg or 25 mg/kg/day PO divided QID for 7 days in patients <40 kg or
Amoxicillin-clavulanate 875 mg/125 mg PO BID for 7 days in adults or 25 mg amoxicillin/kg/day PO divided BID in children for 7 days
Widespread (complicated) impetigo with confirmed MRSA 
Widespread (complicated) impetigo with confirmed MRSA is treated as follows: