Background: Impetigo is a highly contagious superficial bacterial skin infection commonly affecting children, although adults may also be affected. It is primarily caused by Staphylococcus aureus and Streptococcus pyogenes. Topical antibiotics remain the cornerstone of treatment for localized disease. Mupirocin has long been used as a standard therapy; however, emerging bacterial resistance has prompted interest in newer agents such as retapamulin. This study aimed to compare the efficacy and safety of topical mupirocin and retapamulin in the treatment of impetigo.

Methods: A prospective comparative study was conducted among clinically diagnosed cases of localized impetigo attending the dermatology outpatient department. Patients were allocated into two treatment groups. Group A received topical mupirocin 2% ointment applied three times daily, while Group B received topical retapamulin 1% ointment applied twice daily for five days. Clinical assessment was performed at baseline and during follow-up visits to evaluate the reduction in erythema, crusting, vesicopustular lesions, pruritus, and overall clinical cure. Adverse events and treatment compliance were also recorded.

Results: Both treatment groups demonstrated significant clinical improvement following therapy. Patients treated with retapamulin showed a comparable, and in some cases earlier, reduction in lesion count and crust formation compared with those receiving mupirocin. The overall clinical cure rates at the end of treatment were similar between the two groups, with no statistically significant difference. Both medications were well tolerated, and only mild local adverse effects, such as transient irritation or burning sensation, were reported. Compliance was observed to be better in the retapamulin group, likely due to its less frequent dosing schedule.

Conclusion: Topical retapamulin is as effective and safe as mupirocin in the management of localized impetigo. Its twice-daily application may enhance patient adherence and offer a valuable alternative, particularly in settings where concerns regarding mupirocin resistance exist. Further large-scale randomized studies with microbiological correlation are recommended to establish long-term comparative effectiveness and resistance patterns.

Yasmin Ara Zaman is a Consultant Dermatologist and Aesthetic Medicine Specialist committed to providing evidence-based care for skin, hair, and nail conditions. With advanced qualifications in Dermatology & Venereology, including FCPS and an international Fellowship in Aesthetic Medicine from Germany, she offers personalized treatments using the latest medical and aesthetic technologies.

Currently serving as a Consultant and Joint Medical Director at Dhaka Dermatology Institute, she specializes in clinical dermatology, laser treatments, Botox, fillers, PRP therapy, chemical peels, and anti-aging procedures. She is also actively involved in medical education and research, ensuring her patients benefit from the latest advancements in dermatological care.