Prescribe oral antibiotics for impetigo if topical treatment, such as hydrogen peroxide 1% cream, is ineffective for localized non-bullous impetigo NICE CKS.
Consider oral antibiotics if impetigo becomes widespread after initial topical treatment NICE CKS.
Use oral antibiotics when topical antibiotics are unsuccessful, especially if there is a risk of inadequate application or coverage of all infected areas NICE CKS.
In cases of recurrent impetigo, microbiological testing and possible decolonization should be considered, and antibiotics prescribed based on microbiological results NICE CKS.
Opt for oral antibiotics when the infection is moderate or severe, or if there is clinical judgment that oral therapy is more appropriate than topical treatment NICE CKS.