Impetigo affects millions of children worldwide. Most guidelines recommend
antibiotics as first-line treatment; however, topical
antiseptics present a potentially valuable, understudied,
antibiotic-sparing treatment for mild
impetigo. We aimed to determine the feasibility of a randomised controlled trial (RCT) comparing efficacy of soft white
paraffin (SWP),
hydrogen peroxide (H2O2) and
mupirocin for mild
impetigo. Participants were recruited from general practices and randomly assigned one of three treatments. Size and number of lesions were measured at the initial consultation and day six. Post-recruitment, interviews with general practitioners were transcribed and themes identified to determine protocol acceptability, recruitment barriers and avenues to improve delivery. Two participants received SWP (n = 1) and
mupirocin (n = 1). Both commenced oral
antibiotics following failure of assigned topical treatment in which lesions increased in size or number. Recruitment barriers included reduced presentation of
impetigo due to
COVID-19, pre-treatment with existing at-home medications and moderate/severe
infection. Childcare centers and pharmacies were identified as alternative venues to improve the recruitment rate. Valuable insight was gained into the practicality of conducting a RCT of
impetigo treatments in general practice. Future trials should consider recruiting outside of general practice clinics to capture patients at earlier, more mild stages of
infection. Further investigation into the prevalence and impact of use of at-home expired
antibiotics may be beneficial.