Impetigo in immunocompetent children is usually treated by topical antibacterial agents. Antibiotics and antiseptics are available for that purpose. However, the risk for induction of antibiotic resistance has been pointed out repeatedly. The present randomized comparative intra-individual trial was undertaken in order to compare the clinical efficacy of fusidic acid cream (FA) and povidone iodine gel (PVP-I). A total of 52 children were enrolled. They were diagnosed with impetigo affecting at least the upper limbs. A bacteriological search was performed. Lesions on the left and right limbs were compared when treated twice daily for 4 weeks with one or the other formulation. The clinical assessments were performed twice weekly until healing. Staphylococcus aureus was found in the vast majority (84.6%) of the cases. At the issue of the first week of treatment, 24/52 (46.2%) of the PVP-I-treated lesions were apparently cured compared to 17/52 (32.6%) of the FA-treated lesions (p < 0.05). At completion of the treatment, cure was initially obtained in 32/52 (61.5%) of the PVP-I-treated sites compared to 8/52 (15.4%) of the AF-treated sites (p < 0.001). Clinical cure occurred simultaneously on both sites in 23.1% of the cases. No significant difference was disclosed between the median times until cure for the 2 treatments. In conclusion, the cure rate, the therapeutic cost and the risk level for bacterial resistance suggest to use PVP-I rather than FA for treating impetigo Buy this Article