Before 1980, superficial pyodermas in the US were caused primarily by streptococci. Studies conducted in Miami show that during the early 1980s, the predominant pathogen associated with impetigo in pediatric patients shifted from Streptococcus pyogenes to Staphylococcus aureus. Subsequent reports revealed a trend of increasing resistance of S. aureus to penicillins. By regular monitoring of local sensitivity patterns physicians are more likely to select the appropriate antibiotic. The current recommendation for the treatment of pediatric skin disease is cephalosporins due to their low likelihood of resistance by S. aureus.