Abstract: Ninety-seven patients with impetigo were prospectlvely enrolled in a study to determine the comparative efficacy of systemic and topical antibiotic therapy. After obtaining a bacterial culture from a representative losion, the children were randomized to receive seven days of either oral erythromycin or topical mupirocin administered three times daiiy. Staphylococcus aureus aione was Isoiated from 51% and in association with group A β-hemoiytic streptococci (GABS) from 29%; GABS aione was isoiated from 4% of patients. Of 48 children who received erythromycln, 43 (90%) were citnicaily improved or cured, and 11 of 17 were bacteriologicaliy cured. Of 49 children who received mupirocin, 47 (96%) were clinicaily improved or cured, and 10 of 14 were bacterioiogicaiiy cured. At three week foliow-up, clinical cure rates and number of secondary househoid cases of impetigo were equivaient In both treatment groups. Mupirocin appears to be a weil-toierated, aibeit expensive, aiternative to erythromycin for the treatment of impetigo.