What should you know about impetigo after antibiotics?

Crusting or redness can take time to settle even when bacteria are responding, but new spots, spreading lesions or ongoing ooze may mean the treatment needs review. The original diagnosis may also need checking because cellulitis, an allergic reaction or another skin problem can look similar. Antibiotic choice, missed doses, vomiting, medicine interactions or infection in a close contact can affect recovery. Avoid sharing creams or using leftover antibiotics, since they may be unsuitable and can obscure the skin's appearance.

Complete the prescribed course unless a clinician tells you to stop, and arrange a review if improvement is not clear. Gently wash affected areas, pat them dry and avoid picking the crusts. Cover lesions when practical, wash hands after touching them, and do not share towels, clothing, bedding or personal items. Keep fingernails short and wash fabrics that contact the sores. Children may need advice about staying away from school or activities until they are no longer considered infectious.

Seek same-day medical advice if the rash is rapidly spreading, painful, hot or swollen, or if fever develops. Urgent assessment is needed for swelling around the eyes, severe illness, confusion, breathing difficulty or signs of dehydration. Arrange review sooner for an infant, a person with reduced immunity or sores near the eyes. A clinician may change treatment only after examining the skin and considering the response so far.

Ask whether the skin still looks like impetigo, whether a swab or different treatment is needed, how long to continue the current medicine, when infection risk falls, and how to protect household contacts.