How long does my child need to stay away from school or daycare?
States each have their own timeout rules for health conditions. The Queensland government timeout guideline states “Exclude until person has received appropriate antibiotics for at least 24 hours. Cover weeping or crusted sores on exposed areas with a watertight dressing until at least 24 hours after commencing antibiotics and for as long as practical. Sores are not contagious if covered, or after the child has taken antibiotics for 24 hours.”
It is common for a GP to see a whole family who have passed school sores to each other.
Cover the sores at home as well when there are playmates or sibilings around.
What is the treatment for School Sores?
Very mild cases might go away on their own. However, this risks the condition spreading and infecting other people. Antibacterials are the treatment of choice.
Mild cases can be treated with antibiotic cream or ointment. Wash any crusts off first. Usual treatment in Australia is Mupirocin (®Bactroban) that is applied three times per day for 10 days.
More widespread infections will need oral antibiotics such as Flucloxacillin or Dicloxacillin or Cefalexin for 5-10 days.
It’s probably fair to say that kids are often treated with oral antibiotics for mild school sores when topicals might do the job just as well.
Clearly, it’s very disruptive to a family for a child to be out of daycare for any longer than is necessary – for example, in a child who doesn’t respond to topical antibiotic and subsequently needs oral antibiotics. On the other hand, antibiotic resistance is now “an urgent global health priority.” Overall, the guidelines are very clear that topical antibiotics are preferred to oral antibiotics for mild cases¹.
How do I treat recurrences?
Recurrences are common in children and may be caused by infection off playmates or auto-infection (infecting themselves).
Your GP may suggest a swab just inside the nose for staph that may be harbouring there. It may also be worth getting a swab of an infected lesion to check for unusual bacteria. In addition, resistant staph such as MRSA can cause impetigo.
There are various methods to try to reduce staph carriage on the skin. These methods also apply to kids who get recurrently infected eczema.
- Antibacterial soaps – some come as bars, some as dispensers.
- Antibacterial Bath products. Manufacturers such as QV, Cetaphil and Dermeze produce these.
- ®Condys Crystals in the bath.
- Chlorhexidine in the bath.
- sodium hypochlorite baths.
There isn’t hard evidence to say which of these methods is best, or indeed if they work. However, it is usual to recommend an antiseptic bath for children with recurrent impetigo because it just might stop another disruptive round of School Sores.
You can find more information from health direct australia.