Summary

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• Xepi (ozenoxacin) is indicated for the topical treatment of impetigo caused by Staphylococcus aureus or Streptococcus pyogenes in adult and pediatric patients 2 months of age and older.
• This summary is based on the review of two systematic review(s)/meta-analysis(es). ^[1-2]
• Ozenoxacin: In nonendemic settings, ozenoxacin 1% cream demonstrated superior effectiveness in treating impetigo compared to retapamulin and a new minocycline formulation. It was also identified as a costlier but effective alternative to mupirocin and retapamulin.
• Retapamulin: Retapamulin was effective in treating impetigo in nonendemic settings but less so than ozenoxacin. It was effective against lesions colonized by MSSA and Streptococcus pyogenes but not MRSA.
• Oral Co-trimoxazole and Benzathine Benzylpenicillin G: Both treatments were equally effective in treating severe impetigo in endemic settings. Mass drug administration was suggested as a strategy to reduce impetigo prevalence in these settings.
• Adverse events for both ozenoxacin and retapamulin were minimal, with pruritus at the application site being the most commonly reported adverse event.
• All evaluated topical antibiotics demonstrated greater resolution of impetigo with minimal adverse events compared to the vehicle.
• Studies indicate that impetigo primarily affects the pediatric population. Effectiveness of treatments varies by setting, with ozenoxacin and retapamulin being effective in nonendemic settings, while oral co-trimoxazole and benzathine benzylpenicillin G are effective in endemic settings. Mupirocin shows clinical efficacy against MRSA, while retapamulin does not, making bacterial culture necessary to rule out resistance.