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Home > About Newcastle Hospitals > Information leaflets and helpful resources > MRSA standard eradication therapy (pre-surgery eradication-7 days (3-1-3)

MRSA standard eradication therapy (pre-surgery eradication-7 days (3-1-3)

Start using it three days before your hospital admission, continue the day you are admitted, and for three days after your procedure.

Nose

Standard therapy

  • 1st line Mupirocin nasal ointment 2% Apply to the insides of both nostrils 3 times daily for 7 days

Alternatives

(Used in the same way as the standard eradication therapy unless stated)

  • 2nd line Naseptin Nasal® cream Apply to the insides of both nostrils 4 times daily for 10 days
  • 3rd Line Octenisan® nasal gel 0.5% Apply to the insides of both nostrils 2 times daily for 7 days

Notes

In pregnancy and breastfeeding use Naseptin.

Patients with known or suspected peanut or soya allergy must not be prescribed Naseptin®.

Skin

Standard therapy

  • Antimicrobial Hibiwash® (Chlorhexadine 4%) (e.g. Hibiscrub), use as a soap substitute for 7 days
  • Apply the solution directly to wet skin. Wash thoroughly, rinse off, and repeat the process once more.

Alternatives

(Used in the same way as the standard eradication therapy unless stated)

  • Octenisan® wash lotion, use as soap substitute for 7 days
  • Daily application of neat solution applied directly to wet skin, 1 minute contact time

Hair

Standard therapy

  • Antimicrobial Hibiwash® (Chlorhexadine 4%) use as shampoo substitute.
  • Apply the solution directly to wet hair, making sure the hair is fully covered.
  • Leave it on for a few minutes, then rinse thoroughly with water.
  • Use every other day for one week (7 days).

Alternatives

(Used in the same way as the standard eradication therapy unless stated)

  • Octenisan® wash lotion, use as shampoo substitute.
  • Apply the solution directly to wet hair, making sure the hair is fully covered.
  • Leave it on for one minute, then rinse thoroughly with water. Use every other day for one week (7 days).

Throat

Standard therapy

  • Chlorhexidine 0.2% mouthwash 10mls, gargled twice daily for 7 days (rinse mouth with water before using mouthwash)

Notes

  • Patients with dentures should clean these in the normal way and use the Chlorhexidine 0.2% mouthwash A prior to placing the dentures in the mouth.
  • For paediatric patients please see note 1 & 2 below.

Notes

  1. The decision to eradicate throat carriage in children should be made on an individual basis by the team looking after the patient and as required in consultation with the IPCT, as administration could be difficult due to the age and cooperation of the child. Nasal ointment and throat spray should not be given to small babies if there is a risk the treatment will occlude the airway.
  2. Neonates should always be discussed on an individual basis. A neonate is defined as being less than four weeks post term equivalent.
  3. Treatment should not be given for more than three courses to individual patients in any one episode to avoid the development of resistance and should not be given for courses longer than those shown in the table unless agreed by a Microbiologist.
  4. Eradication Therapy is not always successful. It is most likely to be successful in patients with only nasal carriage. Contact the IPCT for advice on the management of persistent carriage of MRSA.