Efficacy and cost effectiveness comparision between fusidic acid and mupirocin for impetigo

Introduction: Impetigo is a contagious skin infection due to S. aureus or S. pyogenes that usually affects children. BNF recommends topical fusidic acid or mupirocin for impetigo. This study compares the efficacy and cost-effectiveness of topical fusidic acid and mupirocin in treatment of impetigo. Materials and Methods: This was an open label, prospective study done on 100 impetigo patients attending OPD of Viswabharathi General & Teaching Hospital, Kurnool, Andhra Pradesh, India from January 2016 to December 2016. The primary end points were evaluated at the baseline, and after one week of treatment. The end points were: number of lesions, size of the lesions, SSI score and cost to treat a single case. Patients were randomly allocated to two groups – fusidic acid group and mupirocin group. In both groups the test drug was applied locally thrice daily. Statistical analysis was done using student’s paired t test and unpaired t test. p-value of Results: In fusidic acid group; number of lesions declined from 4.24±1.17 to 0.24±0.82, wound area (cm2) decreased from 3.24±0.95 to 0.34±1.18 and SSI decreased from 2.32±0.47 to 0.14±0.49. While in mupirocin group; number of lesions declined from 4.16±1.11 to 0.14±0.70, wound area (cm2) decreased from 3.45±1.14 to 0.17±0.85 and SSI decreased from 2.44±0.50 to 0.08±0.39. All these changes were statistically significant. Cost to treat one case was INR 46 for fusidic acid and INR 72 for mupirocin. Conclusion: Mupirocin is marginally more effective than fusidic acid but this difference was not statistically significant. Cost effectiveness of fusidic acid is less than mupirocin. Keywords: Fusidic acid, Mupirocin, Impetigo, Cost-effectiveness, Efficacy, Comparison.