MRSA colonisation (eradicating colonisation in people without active/invasive infection)

BMJ Clin Evid. 2011 Jan 17;2011:0923.


Introduction: Methicillin-resistant Staphylococcus aureus (MRSA) has a gene that makes it resistant to methicillin as well as to other beta-lactam antibiotics, including flucloxacillin, beta-lactam/beta-lactamase inhibitor combinations, cephalosporins, and carbapenems. MRSA can be part of the normal body flora (colonisation), especially in the nose, but it can cause infection. Until recently, MRSA has primarily been a problem associated with exposure to the healthcare system, especially in people with prolonged hospital admissions, with underlying disease, or after antibiotic use. In many countries worldwide, a preponderance of S aureus bloodstream isolates are resistant to methicillin.

Methods and outcomes: We conducted a systematic review and aimed to answer the following clinical question: What are the effects of treatment for MRSA nasal or extra-nasal colonisation? We searched: Medline, Embase, The Cochrane Library, and other important databases up to January 2010 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).

Results: We found 9 systematic reviews, RCTs, or observational studies that met our inclusion criteria.

Conclusions: In this systematic review we present information relating to the effectiveness and safety of the following interventions: antiseptic body washes, chlorhexidine-neomycin nasal cream, mupirocin nasal ointment, systemic antimicrobials, tea tree oil preparations, and other topical antimicrobials.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Administration, Oral
  • Cross Infection / drug therapy
  • Humans
  • Incidence
  • Methicillin Resistance* / drug effects
  • Methicillin-Resistant Staphylococcus aureus*
  • Mupirocin / pharmacology
  • Staphylococcal Infections / drug therapy
  • Staphylococcus aureus / drug effects
  • Tea Tree Oil / pharmacology
  • beta-Lactamase Inhibitors / pharmacology


  • beta-Lactamase Inhibitors
  • Tea Tree Oil
  • Mupirocin