Re: [asid-ozbug] Staph decolonisation: at the coal face

[Matthias Maiwald (KKH)]

Hi Asha, hi Meryta,

We here use 5 days mupirocin for the nose and chlorhexidine body washes, similar to what most people seem to do. Babies receive octenidine (not available in Australia apparently) instead of chlorhexidine for the body.

However, a relatively successful (in terms of achieved decolonization rates) protocol from the literature also includes the mouth, based on the (apparent) rationale that the throat is an often-overlooked reservoir:

Buehlmann M, Frei R, Fenner L, Dangel M, Fluckiger U, Widmer AF. Highly effective regimen for decolonization of methicillin-resistant Staphylococcus aureus carriers. Infect Control Hosp Epidemiol. 2008 Jun;29(6):510-6. doi: 10.1086/588201.
http://www.ncbi.nlm.nih.gov/pubmed/18510460

I can pass the question back. Is anyone else doing the mouth?

Regards, Matthias.

—
Matthias Maiwald, MD, FRCPA
Consultant in Microbiology
Adj. Assoc. Prof., Natl. Univ. Singapore
Department of Pathology and Laboratory Medicine
KK Women’s and Children’s Hospital
100 Bukit Timah Road
Singapore 229899
Tel. +65 6394 8725 (Office)
Tel. +65 6394 1389 (Laboratory)
Fax +65 6394 1387

From: ASHA BOWEN [mailto:Asha.Bowen@menzies.edu.au]
Sent: Wednesday, 25 February, 2015 3:56 PM
To: Meryta May; asid-ozbug@burnet.edu.au
Subject: Re: [asid-ozbug] Staph decolonisation: at the coal face

Good question Meryta

I just looked at our protocol again. 5 days for both nasal mupirocin and daily washes. I didn’t write the protocol, but this has always been my practice. It is probably a mixture of evidence, pragmatics and history. A head-to-head trial of the various lengths of therapy would be interesting.

Asha

________________________________
From: Meryta May [Meryta_May@snp.com.au]
Sent: Friday, 20 February 2015 2:24 PM
To: asid-ozbug@burnet.edu.au
Subject: [asid-ozbug] Staph decolonisation: at the coal face
Dear Ozbug,

Irrespective of what the literature shows, can I ask the following as a quick straw poll:

In your current favourite staph decolonisation protocol how many days do you usually recommend? If you have time to give a quick reason that would be great too (eg based on cast-iron evidence; based on previous failures; patient acceptance, a whim; etc).

Nasal mupirocin: 5, 7, 10, other?

Daily washes: 5, 7, 10, 14 , other?

Many thanks

Meryta

Regards, Dr Meryta May|Clinical Microbiologist and Paediatric Infectious Disease Specialist|Microbiology Department|Microbiology|Sullivan Nicolaides Pathology
P + 61 7 33778402| F +61 7 38705971| E meryta_may@snp.com.au

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